Antenatal care: 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.

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OBG · Antenatal care

Sample item

A 26-week monochorionic diamniotic twin pregnancy shows one twin with oligohydramnios (maximum vertical pocket under 2 cm) and a small bladder, and the other with polyhydramnios (above 8 cm) and a distended bladder. What is the best treatment for this condition if it is severe and early?

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

The answer and the reasoning

B. Fetoscopic laser photocoagulation of placental anastomoses

This is twin-to-twin transfusion syndrome, caused by unbalanced vascular anastomoses in the shared placenta. The donor has oliguria and oligohydramnios, while the recipient has polyuria and polyhydramnios. Fetoscopic laser ablation of the anastomoses treats the cause and gives better outcomes than serial amnioreduction.

Option by option

  • A. Elective delivery with steroid cover at any gestation

    Delivery at 26 weeks carries high prematurity risks and is not the preferred first step.

  • B. Fetoscopic laser photocoagulation of placental anastomoses (correct)

    Correct. Laser separates the shared circulation and addresses the cause.

  • C. Cervical cerclage

    Cerclage does not address the underlying placental pathology.

  • D. Amnioreduction repeated until term without further treatment

    Amnioreduction only relieves symptoms and has worse neurological outcomes than laser.

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, Fetoscopic laser photocoagulation of placental anastomoses. This is twin-to-twin transfusion syndrome, caused by unbalanced vascular anastomoses in the shared placenta.

Why is "Elective delivery with steroid cover at any gestation" not the answer?

Delivery at 26 weeks carries high prematurity risks and is not the preferred first step.

Why is "Cervical cerclage" not the answer?

Cerclage does not address the underlying placental pathology.

Why is "Amnioreduction repeated until term without further treatment" not the answer?

Amnioreduction only relieves symptoms and has worse neurological outcomes than laser.

What concept does this question test?

It tests Antenatal care in OBG. The donor has oliguria and oligohydramnios, while the recipient has polyuria and polyhydramnios. Fetoscopic laser ablation of the anastomoses treats the cause and gives better outcomes than serial amnioreduction.

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 Antenatal care?

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.