Complications of pregnancy: indication for classical caesarean: 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 · Complications of pregnancy: indication for classical caesarean

Sample item

In which situation is a classical (vertical upper segment) uterine incision most appropriate?

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

The answer and the reasoning

C. Extreme preterm breech with an undeveloped lower segment

A classical incision gives more room when the lower segment is not formed, as in extreme prematurity, or with a transverse lie with the back down or a large anterior placenta praevia. Its drawbacks are more bleeding and a higher risk of scar rupture in a later labour, so repeat delivery is by caesarean before labour.

Option by option

  • A. Obstructed labour with the head deep in the pelvis

    With a deeply engaged head the lower segment is thin and stretched, so a low transverse incision remains the choice.

  • B. Elective repeat caesarean at 39 weeks

    A well-formed lower segment at term is entered through a low transverse incision.

  • C. Extreme preterm breech with an undeveloped lower segment (correct)

    Correct. An unformed lower segment with a small preterm breech is the standard indication.

  • D. Failed induction at term in a primigravida

    At term after a failed induction the lower segment is well developed, so a low transverse incision is used.

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 C, Extreme preterm breech with an undeveloped lower segment. A classical incision gives more room when the lower segment is not formed, as in extreme prematurity, or with a transverse lie with the back down or a large anterior placenta praevia.

Why is "Obstructed labour with the head deep in the pelvis" not the answer?

With a deeply engaged head the lower segment is thin and stretched, so a low transverse incision remains the choice.

Why is "Elective repeat caesarean at 39 weeks" not the answer?

A well-formed lower segment at term is entered through a low transverse incision.

Why is "Failed induction at term in a primigravida" not the answer?

At term after a failed induction the lower segment is well developed, so a low transverse incision is used.

What concept does this question test?

It tests Complications of pregnancy: indication for classical caesarean in OBG. Its drawbacks are more bleeding and a higher risk of scar rupture in a later labour, so repeat delivery is by caesarean before labour.

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 Complications of pregnancy: indication for classical caesarean?

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.