Postpartum haemorrhage and emergencies: planned surgery for placenta accreta: 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 · Postpartum haemorrhage and emergencies: planned surgery for placenta accreta

Sample item

Antenatal MRI in a woman with a previous caesarean section and an anterior placenta praevia shows deep myometrial invasion. Which plan is best?

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

The answer and the reasoning

D. Planned caesarean by a multidisciplinary team, with the placenta left undisturbed

In a suspected invasive placenta, removal of the placenta can cause torrential bleeding. A scheduled operation in a unit with blood products, anaesthetic and surgical expertise, with the incision placed to avoid the placenta, is safest. The placenta is left in place and hysterectomy is done, or the uterus is conserved selectively.

Option by option

  • A. Expectant management until spontaneous labour at term

    Spontaneous labour risks emergency surgery with major bleeding and an unprepared team.

  • B. Elective caesarean with prompt manual removal of the placenta

    Manual removal of an invasive placenta provokes massive haemorrhage.

  • C. Induction of labour, then manual removal under anaesthesia

    Labour with manual removal is unsafe when the placenta is praevia and invasive.

  • D. Planned caesarean by a multidisciplinary team, with the placenta left undisturbed (correct)

    Correct. Planned multidisciplinary surgery without attempting placental removal limits haemorrhage.

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, Planned caesarean by a multidisciplinary team, with the placenta left undisturbed. In a suspected invasive placenta, removal of the placenta can cause torrential bleeding.

Why is "Expectant management until spontaneous labour at term" not the answer?

Spontaneous labour risks emergency surgery with major bleeding and an unprepared team.

Why is "Elective caesarean with prompt manual removal of the placenta" not the answer?

Manual removal of an invasive placenta provokes massive haemorrhage.

Why is "Induction of labour, then manual removal under anaesthesia" not the answer?

Labour with manual removal is unsafe when the placenta is praevia and invasive.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: planned surgery for placenta accreta in OBG. A scheduled operation in a unit with blood products, anaesthetic and surgical expertise, with the incision placed to avoid the placenta, is safest. The placenta is left in place and hysterectomy is done, or the uterus is conserved selectively.

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 Postpartum haemorrhage and emergencies: planned surgery for placenta accreta?

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.