Antenatal care: preterm prelabour rupture of membranes: 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 · Antenatal care: preterm prelabour rupture of membranes

Sample item

A woman at 30 weeks has a gush of clear fluid from the vagina. Speculum examination confirms pooling of liquor. She has no contractions, no fever, and the fetal heart rate is normal. What is the most appropriate management?

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

The answer and the reasoning

D. Admit, give antenatal corticosteroids and antibiotics such as erythromycin, and monitor for chorioamnionitis with expectant management

In preterm prelabour rupture of membranes without infection or fetal compromise, expectant management lowers the risks of prematurity. Antenatal corticosteroids improve neonatal lung maturity, and antibiotics (erythromycin, with amoxicillin in some regimens) prolong latency and reduce infection. Digital examination is avoided because it increases infection risk, and the woman is monitored for chorioamnionitis (fever, maternal tachycardia, uterine tenderness, foul liquor). Delivery is considered from about 34 weeks, earlier if infection or fetal compromise develops.

Option by option

  • A. Tocolysis with nifedipine for several weeks

    Prolonged tocolysis is not recommended after membrane rupture.

  • B. Immediate induction of labour with oxytocin

    Immediate induction at 30 weeks would add the risks of extreme prematurity without a need.

  • C. Digital vaginal examination to assess the cervix, then discharge

    Digital examination raises infection risk and discharge is unsafe.

  • D. Admit, give antenatal corticosteroids and antibiotics such as erythromycin, and monitor for chorioamnionitis with expectant management (correct)

    Correct. Corticosteroids, antibiotics and close monitoring balance maturity against the risk of infection.

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 D, Admit, give antenatal corticosteroids and antibiotics such as erythromycin, and monitor for chorioamnionitis with expectant management. In preterm prelabour rupture of membranes without infection or fetal compromise, expectant management lowers the risks of prematurity.

Why is "Tocolysis with nifedipine for several weeks" not the answer?

Prolonged tocolysis is not recommended after membrane rupture.

Why is "Immediate induction of labour with oxytocin" not the answer?

Immediate induction at 30 weeks would add the risks of extreme prematurity without a need.

Why is "Digital vaginal examination to assess the cervix, then discharge" not the answer?

Digital examination raises infection risk and discharge is unsafe.

What concept does this question test?

It tests Antenatal care: preterm prelabour rupture of membranes in OBG. Antenatal corticosteroids improve neonatal lung maturity, and antibiotics (erythromycin, with amoxicillin in some regimens) prolong latency and reduce infection. Digital examination is avoided because it increases infection risk, and the woman is monitored for chorioamnionitis (fever, maternal tachycardia, uterine tenderness, foul liquor). Delivery is considered from about 34 weeks, earlier if infection or fetal compromise develops.

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: preterm prelabour rupture of membranes?

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.