Complications of pregnancy: contraindication to tocolysis: 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: contraindication to tocolysis

Sample item

A woman at 30 weeks with threatened preterm labour is being considered for tocolysis to allow antenatal corticosteroids to act. In which situation should tocolysis be avoided?

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

The answer and the reasoning

D. Clinical chorioamnionitis

Tocolysis is contraindicated when continuing the pregnancy is dangerous, as in intrauterine infection, placental abruption, severe pre-eclampsia, fetal death or a lethal anomaly, and in fetal compromise. Its purpose is to gain 48 hours for steroids and transfer, which is a valid indication.

Option by option

  • A. Intact membranes with 2 cm dilatation

    Intact membranes with early dilatation is the typical situation in which tocolysis is considered.

  • B. Twin pregnancy

    Twin pregnancy is not a contraindication, although risk of pulmonary oedema is higher.

  • C. A need to transfer to a centre with a neonatal unit

    Gaining time for in-utero transfer is one of the accepted purposes of tocolysis.

  • D. Clinical chorioamnionitis (correct)

    Correct. Continuing a pregnancy with intra-amniotic infection is harmful, so tocolysis is withheld and delivery is planned.

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, Clinical chorioamnionitis. Tocolysis is contraindicated when continuing the pregnancy is dangerous, as in intrauterine infection, placental abruption, severe pre-eclampsia, fetal death or a lethal anomaly, and in fetal compromise.

Why is "Intact membranes with 2 cm dilatation" not the answer?

Intact membranes with early dilatation is the typical situation in which tocolysis is considered.

Why is "Twin pregnancy" not the answer?

Twin pregnancy is not a contraindication, although risk of pulmonary oedema is higher.

Why is "A need to transfer to a centre with a neonatal unit" not the answer?

Gaining time for in-utero transfer is one of the accepted purposes of tocolysis.

What concept does this question test?

It tests Complications of pregnancy: contraindication to tocolysis in OBG. Its purpose is to gain 48 hours for steroids and transfer, which is a valid indication.

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: contraindication to tocolysis?

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.