Postpartum haemorrhage and emergencies: delayed hypotension in obstetric haemorrhage: 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: delayed hypotension in obstetric haemorrhage

Sample item

A woman with postpartum haemorrhage of 1500 mL has a pulse of 120 per minute but a blood pressure of 110/70 mmHg. Why is the blood pressure still preserved?

AThe oxytocin infusion has produced a pressor effectBThe pulse rate alone shows that blood loss is under 500 mLCAutotransfusion from the contracted uterus has fully replaced the lossDThe expanded blood volume of pregnancy delays hypotension until a large loss

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

The answer and the reasoning

D. The expanded blood volume of pregnancy delays hypotension until a large loss

Blood volume rises by about 40 per cent in pregnancy, so a healthy woman can lose a large volume before blood pressure falls. Tachycardia, cold peripheries and low urine output are earlier signs. A normal blood pressure should not reassure.

Option by option

A. The oxytocin infusion has produced a pressor effect
Oxytocin does not raise blood pressure and can lower it.
B. The pulse rate alone shows that blood loss is under 500 mL
A pulse of 120 signals significant hypovolaemia, not a small loss.
C. Autotransfusion from the contracted uterus has fully replaced the loss
Autotransfusion from the uterus is partial and cannot replace a 1500 mL loss.
D. The expanded blood volume of pregnancy delays hypotension until a large loss (correct)
Correct. The physiological hypervolaemia of pregnancy masks significant loss until late.

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.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, The expanded blood volume of pregnancy delays hypotension until a large loss. Blood volume rises by about 40 per cent in pregnancy, so a healthy woman can lose a large volume before blood pressure falls.

Why is "The oxytocin infusion has produced a pressor effect" not the answer?

Oxytocin does not raise blood pressure and can lower it.

Why is "The pulse rate alone shows that blood loss is under 500 mL" not the answer?

A pulse of 120 signals significant hypovolaemia, not a small loss.

Why is "Autotransfusion from the contracted uterus has fully replaced the loss" not the answer?

Autotransfusion from the uterus is partial and cannot replace a 1500 mL loss.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: delayed hypotension in obstetric haemorrhage in OBG. Tachycardia, cold peripheries and low urine output are earlier signs. A normal blood pressure should not reassure.

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: delayed hypotension in obstetric haemorrhage?

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.