Postpartum haemorrhage and emergencies: uterine inversion: 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 and emergencies: uterine inversion

Sample item

After delivery of the placenta with traction, a woman has profound shock with only modest bleeding and a smooth mass at the introitus with no fundus palpable abdominally. Which drug is withheld until the problem is corrected?

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

The answer and the reasoning

D. Oxytocin

Acute uterine inversion causes neurogenic shock out of proportion to blood loss. The uterus is replaced promptly, for example by the Johnson manoeuvre, and uterotonics are stopped until replacement since contraction would trap the inverted fundus.

Option by option

  • A. Intravenous fluids

    Fluids are needed to treat shock.

  • B. Antibiotics

    Antibiotics are given after replacement and do not hinder it.

  • C. Analgesia

    Analgesia is allowed and helps.

  • D. Oxytocin (correct)

    Correct. Oxytocin makes the contracted ring hinder replacement.

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.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Oxytocin. Acute uterine inversion causes neurogenic shock out of proportion to blood loss.

Why is "Intravenous fluids" not the answer?

Fluids are needed to treat shock.

Why is "Antibiotics" not the answer?

Antibiotics are given after replacement and do not hinder it.

Why is "Analgesia" not the answer?

Analgesia is allowed and helps.

What concept does this question test?

It tests Postpartum haemorrhage and emergencies: uterine inversion in OBG. The uterus is replaced promptly, for example by the Johnson manoeuvre, and uterotonics are stopped until replacement since contraction would trap the inverted fundus.

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 Postpartum haemorrhage and emergencies: uterine inversion?

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.