Complications of pregnancy: cervical insufficiency: 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.

Try it

OBG · Complications of pregnancy: cervical insufficiency

Sample item

A woman has had two painless second-trimester losses at 18 and 20 weeks with a bulging membranes presentation. Which management is most appropriate in her next pregnancy?

AOral nifedipine from 10 weeksBBed rest at 30 weeksCMcDonald cervical cerclage at 12 to 14 weeksDTermination at 12 weeks

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

The answer and the reasoning

C. McDonald cervical cerclage at 12 to 14 weeks

History-indicated cerclage (McDonald or Shirodkar) is placed at 12 to 14 weeks after a normal scan and removed at 36 to 37 weeks. Cervical length surveillance and vaginal progesterone are alternatives in selected women. Tocolytics do not treat cervical weakness.

Option by option

A. Oral nifedipine from 10 weeks
Nifedipine does not correct cervical weakness.
B. Bed rest at 30 weeks
Late bed rest does not prevent early losses.
C. McDonald cervical cerclage at 12 to 14 weeks (correct)
Correct. A prophylactic suture supports the weak cervix.
D. Termination at 12 weeks
Termination is not indicated.

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 C, McDonald cervical cerclage at 12 to 14 weeks. History-indicated cerclage (McDonald or Shirodkar) is placed at 12 to 14 weeks after a normal scan and removed at 36 to 37 weeks.

Why is "Oral nifedipine from 10 weeks" not the answer?

Nifedipine does not correct cervical weakness.

Why is "Bed rest at 30 weeks" not the answer?

Late bed rest does not prevent early losses.

Why is "Termination at 12 weeks" not the answer?

Termination is not indicated.

What concept does this question test?

It tests Complications of pregnancy: cervical insufficiency in OBG. Cervical length surveillance and vaginal progesterone are alternatives in selected women. Tocolytics do not treat cervical weakness.

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: cervical insufficiency?

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.