Antepartum haemorrhage: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Antepartum haemorrhage

Sample item

A woman at 36 weeks has painless vaginal bleeding immediately after spontaneous rupture of membranes. The fetal heart rate becomes sinusoidal and the mother is stable. Ultrasound with Doppler had earlier suggested fetal vessels crossing the internal os. What is the diagnosis and management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Vasa praevia; immediate caesarean section

Vasa praevia is fetal vessels running unsupported in the membranes across the internal os. Rupture of membranes tears these vessels, causing rapid fetal exsanguination, and a sinusoidal tracing signals severe anaemia. Emergency caesarean is required, and the Apt test or Kleihauer test confirms fetal blood if there is time.

Option by option

  • A. Placental abruption; expectant management

    Abruption is painful with a tense uterus, and expectant management would be fatal for this fetus.

  • B. Vasa praevia; immediate caesarean section (correct)

    Correct. Bleeding with membrane rupture and fetal distress implies a torn fetal vessel, and speed is needed.

  • C. Marginal sinus bleed; reassure

    A marginal bleed does not cause fetal anaemia and sinusoidal tracing.

  • D. Cervical ectropion; observe

    Ectropion is a maternal source and does not affect the fetal heart rate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Vasa praevia; immediate caesarean section. Vasa praevia is fetal vessels running unsupported in the membranes across the internal os.

Why is "Placental abruption; expectant management" not the answer?

Abruption is painful with a tense uterus, and expectant management would be fatal for this fetus.

Why is "Marginal sinus bleed; reassure" not the answer?

A marginal bleed does not cause fetal anaemia and sinusoidal tracing.

Why is "Cervical ectropion; observe" not the answer?

Ectropion is a maternal source and does not affect the fetal heart rate.

What concept does this question test?

It tests Antepartum haemorrhage in OBG. Rupture of membranes tears these vessels, causing rapid fetal exsanguination, and a sinusoidal tracing signals severe anaemia. Emergency caesarean is required, and the Apt test or Kleihauer test confirms fetal blood if there is time.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antepartum haemorrhage?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.