Postpartum haemorrhage and emergencies: uterine relaxant in inversion: 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: uterine relaxant in inversion

Sample item

In acute puerperal uterine inversion, replacement under anaesthesia fails because the cervical ring has tightened around the fundus. Which drug is useful before the next attempt?

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

The answer and the reasoning

D. Nitroglycerin, to relax the uterus

A uterine relaxant such as nitroglycerin, a beta-agonist or a halogenated anaesthetic gas relaxes the cervical ring so that the fundus can be pushed back. Oxytocin or other uterotonics are given only after replacement to contract the uterus and prevent re-inversion.

Option by option

  • A. Carboprost, to contract the uterus

    Carboprost causes strong contraction and would make replacement harder.

  • B. Oxytocin infusion, to contract the uterus

    Oxytocin is started after replacement, since earlier contraction tightens the ring.

  • C. Methylergometrine, to contract the uterus

    Ergometrine causes tonic contraction and would tighten the ring.

  • D. Nitroglycerin, to relax the uterus (correct)

    Correct. Relaxation of the ring allows replacement of the fundus.

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, Nitroglycerin, to relax the uterus. A uterine relaxant such as nitroglycerin, a beta-agonist or a halogenated anaesthetic gas relaxes the cervical ring so that the fundus can be pushed back.

Why is "Carboprost, to contract the uterus" not the answer?

Carboprost causes strong contraction and would make replacement harder.

Why is "Oxytocin infusion, to contract the uterus" not the answer?

Oxytocin is started after replacement, since earlier contraction tightens the ring.

Why is "Methylergometrine, to contract the uterus" not the answer?

Ergometrine causes tonic contraction and would tighten the ring.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: uterine relaxant in inversion in OBG. Oxytocin or other uterotonics are given only after replacement to contract the uterus and prevent re-inversion.

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 Postpartum haemorrhage and emergencies: uterine relaxant in inversion?

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.