Postpartum haemorrhage: retained placenta: 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 · Postpartum haemorrhage: retained placenta

Sample item

The placenta has not been delivered 30 minutes after birth in a woman with no active bleeding. What is the next step?

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

The answer and the reasoning

A. Manual removal of the placenta under anaesthesia with antibiotic cover

A placenta retained beyond 30 minutes (WHO) needs manual removal in a theatre under analgesia, with prophylactic antibiotics, because of the risk of haemorrhage and infection. Failure to separate suggests placenta accreta spectrum.

Option by option

  • A. Manual removal of the placenta under anaesthesia with antibiotic cover (correct)

    Correct. Manual removal is indicated at 30 minutes.

  • B. Wait for 6 more hours

    Waiting increases the risk of haemorrhage and infection.

  • C. Hysterectomy

    Hysterectomy is only for accreta with bleeding.

  • D. Ergometrine to open the cervix

    Ergometrine causes cervical constriction and traps the placenta.

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 A, Manual removal of the placenta under anaesthesia with antibiotic cover. A placenta retained beyond 30 minutes (WHO) needs manual removal in a theatre under analgesia, with prophylactic antibiotics, because of the risk of haemorrhage and infection.

Why is "Wait for 6 more hours" not the answer?

Waiting increases the risk of haemorrhage and infection.

Why is "Hysterectomy" not the answer?

Hysterectomy is only for accreta with bleeding.

Why is "Ergometrine to open the cervix" not the answer?

Ergometrine causes cervical constriction and traps the placenta.

What concept does this question test?

It tests Postpartum haemorrhage: retained placenta in OBG. Failure to separate suggests placenta accreta spectrum.

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 Postpartum haemorrhage: retained placenta?

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.