Postpartum haemorrhage and emergencies: missing cotyledon: 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: missing cotyledon

Sample item

After delivery of the placenta, a cotyledon is found missing and the uterus is soft with ongoing bleeding. What is the next step?

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

The answer and the reasoning

C. Explore the uterine cavity under anaesthesia and remove retained tissue

A missing cotyledon implies retained placental tissue, which prevents uterine contraction and causes bleeding. The cavity is explored manually or evacuated under anaesthesia and antibiotic cover, with uterotonics, to remove the tissue.

Option by option

  • A. Observe the bleeding for 24 hours

    Waiting allows continued haemorrhage and infection.

  • B. Repeat controlled cord traction

    The placenta has already been delivered, so cord traction has no role.

  • C. Explore the uterine cavity under anaesthesia and remove retained tissue (correct)

    Correct. Retained tissue must be removed to allow the uterus to contract.

  • D. Give antibiotics alone

    Antibiotics do not remove the retained tissue causing bleeding.

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, Explore the uterine cavity under anaesthesia and remove retained tissue. A missing cotyledon implies retained placental tissue, which prevents uterine contraction and causes bleeding.

Why is "Observe the bleeding for 24 hours" not the answer?

Waiting allows continued haemorrhage and infection.

Why is "Repeat controlled cord traction" not the answer?

The placenta has already been delivered, so cord traction has no role.

Why is "Give antibiotics alone" not the answer?

Antibiotics do not remove the retained tissue causing bleeding.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: missing cotyledon in OBG. The cavity is explored manually or evacuated under anaesthesia and antibiotic cover, with uterotonics, to remove the tissue.

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: missing cotyledon?

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.