Complications of pregnancy: Marfan syndrome and pregnancy: 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: Marfan syndrome and pregnancy

Sample item

A tall woman with arachnodactyly and ectopia lentis is found to have an aortic root of 4.8 cm on echocardiography. She wishes to conceive. What is the most appropriate advice?

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

The answer and the reasoning

D. Dissection risk is high, so repair the root before conceiving

In Marfan syndrome, the haemodynamic load and hormonal effects on the aortic wall of pregnancy raise the risk of dissection, especially when the root exceeds about 4.5 cm. Such women are advised against pregnancy until the root has been repaired. Beta-blockers are given but do not remove the risk.

Option by option

  • A. Pregnancy is safe provided that she delivers vaginally under epidural

    Mode of delivery does not remove the risk from a dilated root during pregnancy.

  • B. Pregnancy is safe because oestrogen protects the aortic wall

    Oestrogen and relaxin weaken the aortic wall rather than protect it.

  • C. Pregnancy is safe provided that she takes a beta-blocker daily

    A beta-blocker lowers wall stress but does not make a 4.8 cm root safe in pregnancy.

  • D. Dissection risk is high, so repair the root before conceiving (correct)

    Correct. A markedly dilated root is a major risk for dissection and calls for repair before pregnancy.

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, Dissection risk is high, so repair the root before conceiving. In Marfan syndrome, the haemodynamic load and hormonal effects on the aortic wall of pregnancy raise the risk of dissection, especially when the root exceeds about 4.

Why is "Pregnancy is safe provided that she delivers vaginally under epidural" not the answer?

Mode of delivery does not remove the risk from a dilated root during pregnancy.

Why is "Pregnancy is safe because oestrogen protects the aortic wall" not the answer?

Oestrogen and relaxin weaken the aortic wall rather than protect it.

Why is "Pregnancy is safe provided that she takes a beta-blocker daily" not the answer?

A beta-blocker lowers wall stress but does not make a 4.8 cm root safe in pregnancy.

What concept does this question test?

It tests Complications of pregnancy: Marfan syndrome and pregnancy in OBG. 5 cm. Such women are advised against pregnancy until the root has been repaired. Beta-blockers are given but do not remove the risk.

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: Marfan syndrome and pregnancy?

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.