Complications of pregnancy: posterior colpotomy: 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: posterior colpotomy

Sample item

A woman with pelvic inflammatory disease has fever despite intravenous antibiotics, and a tender fluctuant mass bulges into the posterior fornix. How is this pelvic abscess drained?

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

The answer and the reasoning

D. Posterior colpotomy

A pelvic abscess in the pouch of Douglas that bulges into the posterior fornix is drained by posterior colpotomy, with a drain left in. This route avoids the peritoneal cavity. Laparoscopic or ultrasound-guided drainage is also used in other settings.

Option by option

  • A. Total abdominal hysterectomy

    Hysterectomy is a last resort for uncontrolled sepsis.

  • B. Suprapubic aspiration

    Suprapubic aspiration would risk spillage and bladder or bowel injury.

  • C. Anterior colpotomy

    The anterior fornix lies in front of the cervix, near the bladder.

  • D. Posterior colpotomy (correct)

    Correct. The abscess pointing into the posterior fornix is drained there.

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 D, Posterior colpotomy. A pelvic abscess in the pouch of Douglas that bulges into the posterior fornix is drained by posterior colpotomy, with a drain left in.

Why is "Total abdominal hysterectomy" not the answer?

Hysterectomy is a last resort for uncontrolled sepsis.

Why is "Suprapubic aspiration" not the answer?

Suprapubic aspiration would risk spillage and bladder or bowel injury.

Why is "Anterior colpotomy" not the answer?

The anterior fornix lies in front of the cervix, near the bladder.

What concept does this question test?

It tests Complications of pregnancy: posterior colpotomy in OBG. This route avoids the peritoneal cavity. Laparoscopic or ultrasound-guided drainage is also used in other settings.

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 of pregnancy: posterior colpotomy?

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.