Maternal and child health: antenatal corticosteroids: 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.

Try it

PSM · Maternal and child health: antenatal corticosteroids

Sample item

A woman at 30 weeks of gestation arrives with regular contractions and cervical dilatation of 3 cm. The facility has no neonatal intensive care. Besides arranging referral, which drug should be given to reduce neonatal respiratory distress syndrome?

AOral prednisolone 40 mg daily for ten daysBIntravenous magnesium sulphate for lung maturationCDexamethasone 6 mg intramuscularly 12 hourly for four dosesDIntramuscular vitamin K to the mother

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

The answer and the reasoning

C. Dexamethasone 6 mg intramuscularly 12 hourly for four doses

Antenatal corticosteroids are recommended for women between 24 and 34 weeks who are at risk of preterm delivery within 7 days. The regimen is dexamethasone 6 mg IM every 12 hours for four doses, which lowers neonatal respiratory distress, intraventricular haemorrhage and mortality.

Option by option

A. Oral prednisolone 40 mg daily for ten days
Oral prednisolone is metabolised by the placenta and does not give adequate fetal levels.
B. Intravenous magnesium sulphate for lung maturation
Magnesium sulphate is used for eclampsia and fetal neuroprotection; it does not mature the lungs.
C. Dexamethasone 6 mg intramuscularly 12 hourly for four doses (correct)
Correct. Dexamethasone for four doses speeds fetal lung maturity in anticipated preterm birth.
D. Intramuscular vitamin K to the mother
Vitamin K to the mother is not part of preterm lung maturation.

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 C, Dexamethasone 6 mg intramuscularly 12 hourly for four doses. Antenatal corticosteroids are recommended for women between 24 and 34 weeks who are at risk of preterm delivery within 7 days.

Why is "Oral prednisolone 40 mg daily for ten days" not the answer?

Oral prednisolone is metabolised by the placenta and does not give adequate fetal levels.

Why is "Intravenous magnesium sulphate for lung maturation" not the answer?

Magnesium sulphate is used for eclampsia and fetal neuroprotection; it does not mature the lungs.

Why is "Intramuscular vitamin K to the mother" not the answer?

Vitamin K to the mother is not part of preterm lung maturation.

What concept does this question test?

It tests Maternal and child health: antenatal corticosteroids in PSM. The regimen is dexamethasone 6 mg IM every 12 hours for four doses, which lowers neonatal respiratory distress, intraventricular haemorrhage and mortality.

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 Maternal and child health: antenatal corticosteroids?

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.