Complications of pregnancy: septic abortion: 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: septic abortion

Sample item

A woman presents with fever, foul-smelling discharge, uterine tenderness and shock after an unsafe abortion. Which is the best initial management?

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

The answer and the reasoning

D. Broad-spectrum IV antibiotics and evacuation of the uterus after starting antibiotics

Septic abortion needs resuscitation, broad-spectrum IV antibiotics covering anaerobes (for example ceftriaxone, gentamicin and metronidazole) and prompt evacuation of retained products. Clostridium welchii infection may cause haemolysis and gas gangrene, requiring hysterectomy.

Option by option

  • A. Misoprostol and observation

    Medical evacuation with observation delays source control.

  • B. Oral antibiotics and discharge

    Oral therapy is inadequate for sepsis.

  • C. Immediate hysterectomy without antibiotics

    Hysterectomy is reserved for refractory infection or clostridial myonecrosis.

  • D. Broad-spectrum IV antibiotics and evacuation of the uterus after starting antibiotics (correct)

    Correct. Antibiotics plus removal of infected tissue is the standard.

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 D, Broad-spectrum IV antibiotics and evacuation of the uterus after starting antibiotics. Septic abortion needs resuscitation, broad-spectrum IV antibiotics covering anaerobes (for example ceftriaxone, gentamicin and metronidazole) and prompt evacuation of retained products.

Why is "Misoprostol and observation" not the answer?

Medical evacuation with observation delays source control.

Why is "Oral antibiotics and discharge" not the answer?

Oral therapy is inadequate for sepsis.

Why is "Immediate hysterectomy without antibiotics" not the answer?

Hysterectomy is reserved for refractory infection or clostridial myonecrosis.

What concept does this question test?

It tests Complications of pregnancy: septic abortion in OBG. Clostridium welchii infection may cause haemolysis and gas gangrene, requiring hysterectomy.

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 Complications of pregnancy: septic abortion?

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.