Complications of pregnancy: antiphospholipid syndrome: 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: antiphospholipid syndrome

Sample item

A woman has had three unexplained first-trimester losses and persistently positive lupus anticoagulant. Which treatment improves live birth in her next pregnancy?

AHigh-dose steroids aloneBLow-dose aspirin with prophylactic LMWHCWarfarin throughout pregnancyDProgesterone alone

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

The answer and the reasoning

B. Low-dose aspirin with prophylactic LMWH

Obstetric antiphospholipid syndrome is treated with low-dose aspirin plus prophylactic low molecular weight heparin from the time of positive pregnancy test. Warfarin is teratogenic, and steroids alone do not improve outcomes and cause maternal morbidity.

Option by option

A. High-dose steroids alone
Steroids alone are not recommended.
B. Low-dose aspirin with prophylactic LMWH (correct)
Correct. Aspirin plus heparin is the evidence-based combination.
C. Warfarin throughout pregnancy
Warfarin causes embryopathy in the first trimester.
D. Progesterone alone
Progesterone alone has no benefit in APS.

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 B, Low-dose aspirin with prophylactic LMWH. Obstetric antiphospholipid syndrome is treated with low-dose aspirin plus prophylactic low molecular weight heparin from the time of positive pregnancy test.

Why is "High-dose steroids alone" not the answer?

Steroids alone are not recommended.

Why is "Warfarin throughout pregnancy" not the answer?

Warfarin causes embryopathy in the first trimester.

Why is "Progesterone alone" not the answer?

Progesterone alone has no benefit in APS.

What concept does this question test?

It tests Complications of pregnancy: antiphospholipid syndrome in OBG. Warfarin is teratogenic, and steroids alone do not improve outcomes and cause maternal morbidity.

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: antiphospholipid syndrome?

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.