Communicable diseases: prevention of neonatal tetanus: 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 · Communicable diseases: prevention of neonatal tetanus

Sample item

A newborn delivered at home with the cord cut by an unsterilised blade develops trismus and spasms on day 7. Which measure, applied before this birth, would have best prevented the illness?

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

The answer and the reasoning

A. Td immunisation of the mother during pregnancy with a clean delivery

Neonatal tetanus is prevented by immunising the mother so that IgG crosses the placenta, together with the three cleans: clean hands, surface and cord cutting. Newborns cannot respond adequately to toxoid at birth, and immunoglobulin is not given routinely to all women.

Option by option

  • A. Td immunisation of the mother during pregnancy with a clean delivery (correct)

    Correct. Maternal immunisation gives passive protection and clean delivery prevents inoculation.

  • B. Tetanus toxoid to the newborn at birth

    A newborn cannot mount a protective response to toxoid at birth.

  • C. Antibiotic prophylaxis to the mother after delivery

    Antibiotics do not neutralise the toxin or give lasting protection.

  • D. Tetanus immunoglobulin to all women in labour

    Routine immunoglobulin for all women is impractical and not the strategy used.

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 PSM question

What is the answer to this PSM question?

The best answer is A, Td immunisation of the mother during pregnancy with a clean delivery. Neonatal tetanus is prevented by immunising the mother so that IgG crosses the placenta, together with the three cleans: clean hands, surface and cord cutting.

Why is "Tetanus toxoid to the newborn at birth" not the answer?

A newborn cannot mount a protective response to toxoid at birth.

Why is "Antibiotic prophylaxis to the mother after delivery" not the answer?

Antibiotics do not neutralise the toxin or give lasting protection.

Why is "Tetanus immunoglobulin to all women in labour" not the answer?

Routine immunoglobulin for all women is impractical and not the strategy used.

What concept does this question test?

It tests Communicable diseases: prevention of neonatal tetanus in PSM. Newborns cannot respond adequately to toxoid at birth, and immunoglobulin is not given routinely to all women.

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 Communicable diseases: prevention of neonatal tetanus?

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.