National programmes: tetanus toxoid in pregnancy: practice question

A PSM 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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PSM · National programmes: tetanus toxoid in pregnancy

Sample item

A primigravida at 12 weeks of gestation has never received a tetanus-containing vaccine. Which schedule is recommended under the national immunisation programme?

ATd as early as possible, then a second dose at least 4 weeks laterBNo vaccine, as tetanus toxoid is not given in pregnancyCTd at 20 weeks with a second dose after deliveryDA single Td dose at 36 weeks

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

The answer and the reasoning

A. Td as early as possible, then a second dose at least 4 weeks later

A pregnant woman not previously immunised receives two doses of Td, the first as early as possible and the second at least 4 weeks later. A woman who was vaccinated in a previous pregnancy within three years gets a single booster. This protects the newborn from neonatal tetanus through transplacental antibodies.

Option by option

A. Td as early as possible, then a second dose at least 4 weeks later (correct)
Correct. Two doses 4 weeks apart in pregnancy protect the mother and the newborn.
B. No vaccine, as tetanus toxoid is not given in pregnancy
Tetanus vaccine is safe in pregnancy and is a core antenatal intervention.
C. Td at 20 weeks with a second dose after delivery
A postpartum dose gives no passive protection to the newborn.
D. A single Td dose at 36 weeks
A single dose at 36 weeks may be too late and one dose is inadequate in a woman never immunised.

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 PSM question

What is the answer to this PSM question?

The best answer is A, Td as early as possible, then a second dose at least 4 weeks later. A pregnant woman not previously immunised receives two doses of Td, the first as early as possible and the second at least 4 weeks later.

Why is "No vaccine, as tetanus toxoid is not given in pregnancy" not the answer?

Tetanus vaccine is safe in pregnancy and is a core antenatal intervention.

Why is "Td at 20 weeks with a second dose after delivery" not the answer?

A postpartum dose gives no passive protection to the newborn.

Why is "A single Td dose at 36 weeks" not the answer?

A single dose at 36 weeks may be too late and one dose is inadequate in a woman never immunised.

What concept does this question test?

It tests National programmes: tetanus toxoid in pregnancy in PSM. A woman who was vaccinated in a previous pregnancy within three years gets a single booster. This protects the newborn from neonatal tetanus through transplacental antibodies.

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 National programmes: tetanus toxoid in pregnancy?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.