Immunisation: tetanus protection in pregnancy: practice question

A Pediatrics 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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Pediatrics · Immunisation: tetanus protection in pregnancy

Sample item

A primigravida at 14 weeks with no prior tetanus immunisation attends an antenatal clinic in India. Which schedule best prevents neonatal tetanus?

AOne Td dose at term during labourBThree doses of DPT at 0, 1 and 6 monthsCTetanus immunoglobulin to the newborn at birthDTwo Td doses 4 weeks apart, the second at least 2 weeks before delivery

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

The answer and the reasoning

D. Two Td doses 4 weeks apart, the second at least 2 weeks before delivery

Neonatal tetanus is prevented by maternal antibody crossing the placenta. A non-immune pregnant woman needs two doses of Td given 4 weeks apart, with the second dose at least 2 weeks before delivery so that antibody can be transferred. A previously immunised woman needs a single booster.

Option by option

A. One Td dose at term during labour
A single dose in labour gives no time for antibody to develop and cross the placenta.
B. Three doses of DPT at 0, 1 and 6 months
DPT is a paediatric vaccine and is not used in pregnant women.
C. Tetanus immunoglobulin to the newborn at birth
Immunoglobulin to the newborn is not the standard preventive strategy.
D. Two Td doses 4 weeks apart, the second at least 2 weeks before delivery (correct)
Correct. Two doses spaced 4 weeks apart, finished 2 weeks before delivery, give protective antibody transfer.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Two Td doses 4 weeks apart, the second at least 2 weeks before delivery. Neonatal tetanus is prevented by maternal antibody crossing the placenta.

Why is "One Td dose at term during labour" not the answer?

A single dose in labour gives no time for antibody to develop and cross the placenta.

Why is "Three doses of DPT at 0, 1 and 6 months" not the answer?

DPT is a paediatric vaccine and is not used in pregnant women.

Why is "Tetanus immunoglobulin to the newborn at birth" not the answer?

Immunoglobulin to the newborn is not the standard preventive strategy.

What concept does this question test?

It tests Immunisation: tetanus protection in pregnancy in Pediatrics. A non-immune pregnant woman needs two doses of Td given 4 weeks apart, with the second dose at least 2 weeks before delivery so that antibody can be transferred. A previously immunised woman needs a single booster.

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 Immunisation: tetanus protection in pregnancy?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.