Complications of pregnancy: Rh isoimmunisation: 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 · Complications of pregnancy: Rh isoimmunisation

Sample item

A woman with an Rh-negative blood group and a previous affected baby has a rising indirect Coombs titre of 1:64. What is the next step in monitoring?

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

The answer and the reasoning

B. Serial MCA peak systolic velocity Doppler

An indirect Coombs titre of 1:16 or more (critical titre) triggers surveillance for fetal anaemia with serial MCA-PSV Doppler. A value above 1.5 MoM prompts cordocentesis and intrauterine intravascular transfusion. Anti-D is useless once sensitisation has occurred.

Option by option

  • A. Check blood sugar

    Blood sugar is not relevant here.

  • B. Serial MCA peak systolic velocity Doppler (correct)

    Correct. MCA-PSV is the non-invasive monitoring tool.

  • C. Ultrasound for placental location

    Placental location does not help monitor anaemia.

  • D. Repeat anti-D at 28 weeks

    Anti-D prophylaxis does not help once sensitised.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Serial MCA peak systolic velocity Doppler. An indirect Coombs titre of 1:16 or more (critical titre) triggers surveillance for fetal anaemia with serial MCA-PSV Doppler.

Why is "Check blood sugar" not the answer?

Blood sugar is not relevant here.

Why is "Ultrasound for placental location" not the answer?

Placental location does not help monitor anaemia.

Why is "Repeat anti-D at 28 weeks" not the answer?

Anti-D prophylaxis does not help once sensitised.

What concept does this question test?

It tests Complications of pregnancy: Rh isoimmunisation in OBG. A value above 1.5 MoM prompts cordocentesis and intrauterine intravascular transfusion. Anti-D is useless once sensitisation has occurred.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Complications of pregnancy: Rh isoimmunisation?

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.