Complications and emergencies: placenta accreta at caesarean: practice question

A Anaesthesia 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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Anaesthesia · Complications and emergencies: placenta accreta at caesarean

Sample item

A woman with two previous caesarean sections and an anterior placenta praevia with imaging features of accreta is booked for caesarean hysterectomy. Which preparation is most important?

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

The answer and the reasoning

D. Large-bore access, cross-matched blood and a massive transfusion plan with a senior team

Placenta accreta carries a risk of life-threatening haemorrhage. Planning includes experienced obstetric, anaesthetic and haematology staff, large-bore access, arterial monitoring, cross-matched blood, cell salvage and a massive transfusion protocol.

Option by option

  • A. A single cannula and spinal anaesthesia alone, since bleeding is rare

    Bleeding is often massive in accreta.

  • B. Group and screen alone, with no blood products on standby

    Products must be immediately available, not requested after bleeding starts.

  • C. An oxytocin infusion alone, to control all the bleeding

    Uterotonics will not control bleeding from an adherent placenta.

  • D. Large-bore access, cross-matched blood and a massive transfusion plan with a senior team (correct)

    Correct. Anticipating massive haemorrhage is the key to safe management.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Large-bore access, cross-matched blood and a massive transfusion plan with a senior team. Placenta accreta carries a risk of life-threatening haemorrhage.

Why is "A single cannula and spinal anaesthesia alone, since bleeding is rare" not the answer?

Bleeding is often massive in accreta.

Why is "Group and screen alone, with no blood products on standby" not the answer?

Products must be immediately available, not requested after bleeding starts.

Why is "An oxytocin infusion alone, to control all the bleeding" not the answer?

Uterotonics will not control bleeding from an adherent placenta.

What concept does this question test?

It tests Complications and emergencies: placenta accreta at caesarean in Anaesthesia. Planning includes experienced obstetric, anaesthetic and haematology staff, large-bore access, arterial monitoring, cross-matched blood, cell salvage and a massive transfusion protocol.

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 Complications and emergencies: placenta accreta at caesarean?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.