Hypertensive disorders: avoiding abrupt fall in pressure: 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 · Hypertensive disorders: avoiding abrupt fall in pressure

Sample item

Why should blood pressure in severe pre-eclampsia be lowered gradually, not precipitously?

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

The answer and the reasoning

B. The uteroplacental circulation lacks autoregulation, so a sudden fall causes fetal distress

The uteroplacental bed is maximally dilated and cannot autoregulate, so perfusion depends on maternal pressure. A sharp fall reduces placental blood flow and can cause fetal hypoxia and bradycardia. The aim is a gradual, controlled reduction.

Option by option

  • A. Rapid lowering worsens proteinuria permanently

    Rapid lowering does not permanently worsen proteinuria.

  • B. The uteroplacental circulation lacks autoregulation, so a sudden fall causes fetal distress (correct)

    Correct. Placental perfusion depends on maternal pressure, so a rapid fall endangers the fetus.

  • C. A sudden fall causes magnesium to be excreted rapidly

    Blood pressure changes do not change magnesium excretion.

  • D. Rapid lowering increases the risk of placenta praevia

    Placenta praevia is a placental location and is not related to blood pressure changes.

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 B, The uteroplacental circulation lacks autoregulation, so a sudden fall causes fetal distress. The uteroplacental bed is maximally dilated and cannot autoregulate, so perfusion depends on maternal pressure.

Why is "Rapid lowering worsens proteinuria permanently" not the answer?

Rapid lowering does not permanently worsen proteinuria.

Why is "A sudden fall causes magnesium to be excreted rapidly" not the answer?

Blood pressure changes do not change magnesium excretion.

Why is "Rapid lowering increases the risk of placenta praevia" not the answer?

Placenta praevia is a placental location and is not related to blood pressure changes.

What concept does this question test?

It tests Hypertensive disorders: avoiding abrupt fall in pressure in OBG. A sharp fall reduces placental blood flow and can cause fetal hypoxia and bradycardia. The aim is a gradual, controlled reduction.

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 Hypertensive disorders: avoiding abrupt fall in pressure?

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.