Labour and delivery: episiotomy: 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 · Labour and delivery: episiotomy

Sample item

Which statement correctly compares median and mediolateral episiotomy?

AMediolateral episiotomy heals better and extends lessBMedian episiotomy has less blood loss and is more painfulCBoth have equal risk of sphincter injuryDMedian episiotomy heals better but extends more often into the anal sphincter

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

The answer and the reasoning

D. Median episiotomy heals better but extends more often into the anal sphincter

Median incisions are easy to repair and heal well but can extend into the anal sphincter. Mediolateral incisions have lower rates of extension but more blood loss and discomfort.

Option by option

A. Mediolateral episiotomy heals better and extends less
Mediolateral cuts heal less well and bleed more.
B. Median episiotomy has less blood loss and is more painful
This reverses the comparison, since a median cut is in fact the less painful one.
C. Both have equal risk of sphincter injury
The two differ in the risk of sphincter injury.
D. Median episiotomy heals better but extends more often into the anal sphincter (correct)
Correct. Better healing comes with greater risk of extension.

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 D, Median episiotomy heals better but extends more often into the anal sphincter. Median incisions are easy to repair and heal well but can extend into the anal sphincter.

Why is "Mediolateral episiotomy heals better and extends less" not the answer?

Mediolateral cuts heal less well and bleed more.

Why is "Median episiotomy has less blood loss and is more painful" not the answer?

This reverses the comparison, since a median cut is in fact the less painful one.

Why is "Both have equal risk of sphincter injury" not the answer?

The two differ in the risk of sphincter injury.

What concept does this question test?

It tests Labour and delivery: episiotomy in OBG. Mediolateral incisions have lower rates of extension but more blood loss and discomfort.

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 and delivery: episiotomy?

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.