Labour: meconium: 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 · Labour: meconium

Sample item

A baby is born through meconium-stained liquor, is limp and not breathing. What is the appropriate initial step according to current neonatal resuscitation guidance?

AWait one minute before doing anythingBGive naloxoneCPlace under a warmer, dry, stimulate and start positive pressure ventilation if apnoeicDRoutine intubation and suction of the trachea in all cases

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

The answer and the reasoning

C. Place under a warmer, dry, stimulate and start positive pressure ventilation if apnoeic

Routine tracheal suction is no longer recommended for non-vigorous infants. The priority is to initiate resuscitation: warmth, positioning, drying, stimulation and positive pressure ventilation within the first minute (the golden minute). Intubation for suction is done only if the airway is obstructed.

Option by option

A. Wait one minute before doing anything
Waiting wastes the golden minute.
B. Give naloxone
Naloxone is not part of routine resuscitation.
C. Place under a warmer, dry, stimulate and start positive pressure ventilation if apnoeic (correct)
Correct. Ventilation takes priority over suction.
D. Routine intubation and suction of the trachea in all cases
Routine tracheal suction delays ventilation.

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, Place under a warmer, dry, stimulate and start positive pressure ventilation if apnoeic. Routine tracheal suction is no longer recommended for non-vigorous infants.

Why is "Wait one minute before doing anything" not the answer?

Waiting wastes the golden minute.

Why is "Give naloxone" not the answer?

Naloxone is not part of routine resuscitation.

Why is "Routine intubation and suction of the trachea in all cases" not the answer?

Routine tracheal suction delays ventilation.

What concept does this question test?

It tests Labour: meconium in OBG. The priority is to initiate resuscitation: warmth, positioning, drying, stimulation and positive pressure ventilation within the first minute (the golden minute). Intubation for suction is done only if the airway is obstructed.

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 Labour: meconium?

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.