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.

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OBG · Antepartum haemorrhage

Sample item

A multigravida with two previous caesarean sections has a placenta praevia covering the os at 32 weeks. Ultrasound shows loss of the retroplacental clear space and multiple lacunae. What is the best plan for delivery?

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

The answer and the reasoning

B. Planned caesarean at a centre with blood bank and surgical expertise, anticipating hysterectomy

Placenta praevia with previous caesarean scars carries a high risk of placenta accreta spectrum, shown by lacunae and loss of the clear zone. Planned preterm caesarean, commonly hysterectomy with the placenta left in situ, is performed by an experienced team with blood products and ICU backup. Attempted manual removal can cause torrential haemorrhage.

Option by option

  • A. Vaginal delivery with active management of the third stage

    Vaginal birth is impossible with a praevia covering the os.

  • B. Planned caesarean at a centre with blood bank and surgical expertise, anticipating hysterectomy (correct)

    Correct. Planned delivery in a prepared centre reduces catastrophic bleeding.

  • C. Induction of labour at 37 weeks

    Labour induction is contraindicated with praevia covering the os.

  • D. Manual removal of placenta in the delivery room after vaginal birth

    Forced removal of an adherent placenta causes life-threatening haemorrhage.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Planned caesarean at a centre with blood bank and surgical expertise, anticipating hysterectomy. Placenta praevia with previous caesarean scars carries a high risk of placenta accreta spectrum, shown by lacunae and loss of the clear zone.

Why is "Vaginal delivery with active management of the third stage" not the answer?

Vaginal birth is impossible with a praevia covering the os.

Why is "Induction of labour at 37 weeks" not the answer?

Labour induction is contraindicated with praevia covering the os.

Why is "Manual removal of placenta in the delivery room after vaginal birth" not the answer?

Forced removal of an adherent placenta causes life-threatening haemorrhage.

What concept does this question test?

It tests Antepartum haemorrhage in OBG. Planned preterm caesarean, commonly hysterectomy with the placenta left in situ, is performed by an experienced team with blood products and ICU backup. Attempted manual removal can cause torrential haemorrhage.

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.