Labour and delivery: cervical effacement in primigravida: 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: cervical effacement in primigravida

Sample item

Which statement describes the usual pattern of cervical changes in the first stage of labour in a primigravida compared with a multigravida?

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

The answer and the reasoning

C. Effacement is mostly complete before dilatation starts

In a primigravida the cervix usually effaces from above downward, so it is nearly paper thin before the external os dilates. In a multigravida, effacement and dilatation proceed simultaneously, which is one reason labour is shorter.

Option by option

  • A. Effacement does not begin until the second stage of labour

    Both change in the first stage, not only in the second stage.

  • B. Dilatation of the os precedes effacement of the canal

    Dilatation before effacement is the pattern seen in some multigravidae with a patulous cervix, not the primigravida.

  • C. Effacement is mostly complete before dilatation starts (correct)

    Correct. In primigravidae the cervical canal is taken up first, then the os dilates.

  • D. Effacement and dilatation proceed together, as in a multigravida

    Simultaneous change is the typical pattern in multigravidae.

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, Effacement is mostly complete before dilatation starts. In a primigravida the cervix usually effaces from above downward, so it is nearly paper thin before the external os dilates.

Why is "Effacement does not begin until the second stage of labour" not the answer?

Both change in the first stage, not only in the second stage.

Why is "Dilatation of the os precedes effacement of the canal" not the answer?

Dilatation before effacement is the pattern seen in some multigravidae with a patulous cervix, not the primigravida.

Why is "Effacement and dilatation proceed together, as in a multigravida" not the answer?

Simultaneous change is the typical pattern in multigravidae.

What concept does this question test?

It tests Labour and delivery: cervical effacement in primigravida in OBG. In a multigravida, effacement and dilatation proceed simultaneously, which is one reason labour is shorter.

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: cervical effacement in primigravida?

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.