Normal pregnancy and antenatal care: coagulation changes: 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 · Normal pregnancy and antenatal care: coagulation changes

Sample item

Pregnancy is a hypercoagulable state. Which of the following coagulation parameters is characteristically decreased in a normal pregnancy?

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

The answer and the reasoning

C. Free protein S level

Fibrinogen and factors VII, VIII, X and von Willebrand factor rise in pregnancy, while the natural anticoagulant protein S falls (and factors XI and XIII drift lower). This tilts the balance towards clotting, which protects against haemorrhage at delivery but increases thrombotic risk.

Option by option

  • A. Plasma fibrinogen level

    Fibrinogen roughly doubles by term, so it is increased.

  • B. von Willebrand factor level

    von Willebrand factor rises through pregnancy.

  • C. Free protein S level (correct)

    Correct. Protein S activity falls in normal pregnancy, which adds to the hypercoagulable state.

  • D. Factor VIII activity

    Factor VIII activity rises significantly during 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 C, Free protein S level. Fibrinogen and factors VII, VIII, X and von Willebrand factor rise in pregnancy, while the natural anticoagulant protein S falls (and factors XI and XIII drift lower).

Why is "Plasma fibrinogen level" not the answer?

Fibrinogen roughly doubles by term, so it is increased.

Why is "von Willebrand factor level" not the answer?

von Willebrand factor rises through pregnancy.

Why is "Factor VIII activity" not the answer?

Factor VIII activity rises significantly during pregnancy.

What concept does this question test?

It tests Normal pregnancy and antenatal care: coagulation changes in OBG. This tilts the balance towards clotting, which protects against haemorrhage at delivery but increases thrombotic risk.

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 Normal pregnancy and antenatal care: coagulation changes?

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.