Antenatal care: malpresentation: 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: malpresentation

Sample item

A 28-year-old primigravida at 37 weeks has a confirmed breech presentation with a normal ultrasound, normal liquor volume and an anterior, fundal placenta. Which is the most appropriate option?

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

The answer and the reasoning

C. Offer external cephalic version

External cephalic version at 36 to 37 weeks in women without contraindications reduces the rate of breech presentation at term and caesarean sections. It is done with tocolysis and ultrasound and fetal monitoring available. Contraindications include placenta praevia, multiple pregnancy, uterine anomalies, recent antepartum haemorrhage and fetal compromise.

Option by option

  • A. Induce labour at once

    Induction in breech does not address the presentation.

  • B. Immediate vaginal breech delivery without counselling

    Vaginal breech delivery needs careful selection and counselling and is not the first option.

  • C. Offer external cephalic version (correct)

    Correct. Version should be offered to suitable women before labour.

  • D. Wait for spontaneous version until labour

    Spontaneous version becomes less likely near term.

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 C, Offer external cephalic version. External cephalic version at 36 to 37 weeks in women without contraindications reduces the rate of breech presentation at term and caesarean sections.

Why is "Induce labour at once" not the answer?

Induction in breech does not address the presentation.

Why is "Immediate vaginal breech delivery without counselling" not the answer?

Vaginal breech delivery needs careful selection and counselling and is not the first option.

Why is "Wait for spontaneous version until labour" not the answer?

Spontaneous version becomes less likely near term.

What concept does this question test?

It tests Antenatal care: malpresentation in OBG. It is done with tocolysis and ultrasound and fetal monitoring available. Contraindications include placenta praevia, multiple pregnancy, uterine anomalies, recent antepartum haemorrhage and fetal compromise.

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: malpresentation?

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.