Labour and delivery: pain pathways in the first stage: 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 · Labour and delivery: pain pathways in the first stage

Sample item

A woman in the first stage of labour requests epidural analgesia. The pain from uterine contractions and cervical dilatation travels via visceral afferents to which spinal segments?

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

The answer and the reasoning

C. T10 to L1

First-stage pain is visceral, carried by sympathetic afferents that enter the cord at T10 to L1 and is referred to the lower abdomen and back. Second-stage perineal pain is carried by the pudendal nerve (S2 to S4).

Option by option

  • A. L4 to L5 only

    L4 to L5 supplies the lower limb and is not the main segment for uterine pain.

  • B. T1 to T4 only

    T1 to T4 supplies the upper chest and arm, not the uterus.

  • C. T10 to L1 (correct)

    Correct. Uterine and cervical afferents enter the cord at T10 to L1.

  • D. S2 to S4

    S2 to S4 carries somatic perineal pain through the pudendal nerve in the second stage.

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, T10 to L1. First-stage pain is visceral, carried by sympathetic afferents that enter the cord at T10 to L1 and is referred to the lower abdomen and back.

Why is "L4 to L5 only" not the answer?

L4 to L5 supplies the lower limb and is not the main segment for uterine pain.

Why is "T1 to T4 only" not the answer?

T1 to T4 supplies the upper chest and arm, not the uterus.

Why is "S2 to S4" not the answer?

S2 to S4 carries somatic perineal pain through the pudendal nerve in the second stage.

What concept does this question test?

It tests Labour and delivery: pain pathways in the first stage in OBG. Second-stage perineal pain is carried by the pudendal nerve (S2 to S4).

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 Labour and delivery: pain pathways in the first stage?

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.