Complications of pregnancy: omphalocele: 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: omphalocele

Sample item

A fetus at 18 weeks has a midline anterior abdominal wall defect with liver and bowel herniating into a membrane-covered sac to which the umbilical cord is attached. What is the most appropriate next step in evaluation?

AReassurance, as this is isolated and benignBImmediate delivery at 20 weeks of gestationCFetal karyotyping and echocardiographyDA repeat scan after 6 months, and nothing else

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

The answer and the reasoning

C. Fetal karyotyping and echocardiography

Omphalocele is frequently associated with aneuploidy (notably trisomy 18 and 13), other structural anomalies including cardiac defects, and syndromes such as Beckwith-Wiedemann. Karyotyping and fetal echocardiography are therefore indicated, in contrast with gastroschisis.

Option by option

A. Reassurance, as this is isolated and benign
Isolated benign behaviour is typical of gastroschisis, not omphalocele.
B. Immediate delivery at 20 weeks of gestation
Delivery at 20 weeks is not viable.
C. Fetal karyotyping and echocardiography (correct)
Correct. Associated anomalies and aneuploidy are common, so karyotype and cardiac evaluation are required.
D. A repeat scan after 6 months, and nothing else
Waiting without karyotyping misses a high-risk association.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Fetal karyotyping and echocardiography. Omphalocele is frequently associated with aneuploidy (notably trisomy 18 and 13), other structural anomalies including cardiac defects, and syndromes such as Beckwith-Wiedemann.

Why is "Reassurance, as this is isolated and benign" not the answer?

Isolated benign behaviour is typical of gastroschisis, not omphalocele.

Why is "Immediate delivery at 20 weeks of gestation" not the answer?

Delivery at 20 weeks is not viable.

Why is "A repeat scan after 6 months, and nothing else" not the answer?

Waiting without karyotyping misses a high-risk association.

What concept does this question test?

It tests Complications of pregnancy: omphalocele in OBG. Karyotyping and fetal echocardiography are therefore indicated, in contrast with gastroschisis.

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: omphalocele?

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.