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 woman at 18 weeks gestation with a known 7 cm uterine fibroid presents with severe focal abdominal pain, low-grade fever and localised uterine tenderness. Ultrasound shows the fibroid with a heterogeneous pattern and no other abnormality. What is the most likely diagnosis and management?

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

The answer and the reasoning

A. Red degeneration; analgesia and conservative management

Red (carneous) degeneration is haemorrhagic infarction of a fibroid, most common in the second trimester when the fibroid outgrows its blood supply. Pain, fever and localised tenderness are typical, and it settles with rest, hydration and analgesia. Surgery is rarely required.

Option by option

  • A. Red degeneration; analgesia and conservative management (correct)

    Correct. It is self-limiting and treated conservatively.

  • B. Torsion of a pedunculated fibroid requiring urgent myomectomy

    Torsion is rare and would not be assumed without imaging evidence of a pedicle.

  • C. Uterine rupture; emergency laparotomy

    Uterine rupture is rare in an unscarred uterus at 18 weeks and has shock and fetal signs.

  • D. Placental abruption; immediate delivery

    Abruption is uncommon at this gestation and causes bleeding with a hard uterus.

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 A, Red degeneration; analgesia and conservative management. Red (carneous) degeneration is haemorrhagic infarction of a fibroid, most common in the second trimester when the fibroid outgrows its blood supply.

Why is "Torsion of a pedunculated fibroid requiring urgent myomectomy" not the answer?

Torsion is rare and would not be assumed without imaging evidence of a pedicle.

Why is "Uterine rupture; emergency laparotomy" not the answer?

Uterine rupture is rare in an unscarred uterus at 18 weeks and has shock and fetal signs.

Why is "Placental abruption; immediate delivery" not the answer?

Abruption is uncommon at this gestation and causes bleeding with a hard uterus.

What concept does this question test?

It tests Antenatal care in OBG. Pain, fever and localised tenderness are typical, and it settles with rest, hydration and analgesia. Surgery is rarely required.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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.