OB

Question 1

What is the most common risk factor for placental abruption?

Answer 1

Hypertension

Question 2

What is the most common risk factor for uterine rupture?

Answer 2

Prior uterine surgery / uterine scar. Associated with 90% of cases

Question 3

What is Couvelaire uterus?

Answer 3

A life-threatening condition that occurs when enough blood from a placental abruption markedly infiltrates the myometrium to reach the serosa, giving the myometrium a bluish purple tone

Question 4

Smoking is associated with what obstetric complications?

Answer 4

Placenta previa, placental abruption, spontaneous abortion, preterm birth, decreased birth weight, fetal death

Question 5

Differentiate preterm ROM, PROM, PPROM and prolonged ROM

Answer 5

PROM = premature rupture of membranes (ROM before labor)
PPROM = preterm PROM

Preterm ROM = ROM before 37 weeks AOG
Prolonged ROM = ROM lasting longer than 18 hours before delivery

Question 6

What is the most common concern of PROM?

Answer 6

Chorioamnionitis

Question 7

Define the obstetric conjugate.

Answer 7

Obstetric conjugate = distance between sacral promontory and midpoint of the pubic symphysis.
It is the shortest anteroposterior diameter of the pelvic inlet.

Question 8

What is the ideal fetal position for vaginal delivery?

Answer 8

Occiput anterior

Question 9

Sharp flexion of the maternal hips that increases the AP diameter to free the anterior shoulder in shoulder dystocia

Answer 9

McRobert’s maneuver

Question 10

During trial of vaginal delivery, placing the infant’s head back into the pelvis and performing CS instead

Answer 10

Zavanelli maneuver

Question 11

Flushing, diplopia and headache are common side effects of which tocolytic drug?

Answer 11

Magnesium sulfate

Question 12

At what stage of pregnancy is eclampsia most likely to occur?

Answer 12

Third trimester (91% of antepartum eclampsia cases)

Question 13

At what age of gestation should the FH be approximately equal to gestational age?

Answer 13

20 weeks AOG

Question 14

Maximum volume of amniotic fluid

Answer 14

800ml, reached by 28 weeks AOG and maintained until close to term when it starts falling to about 500ml at week 40

Question 15

AFI in oligohydramnios and polyhydramnios

Answer 15

Oligohydramnios: AFI 20-25 depending on AOG

Question 16

What complications are associated with oligohydramnios in labor?

Answer 16

Meconium, cesarean section, FHR decelerations, nonreactive fetal tracing

Question 17

Postterm pregnancy is associated with what complications?

Answer 17

Oligohydramnios, macrosomia, meconium aspiration, IUFD

Question 18

HELLP Syndrome stands for

Answer 18

Hemolysis, elevated liver enzymes, low platelets

Question 19

Smoking decreases the risk of

Answer 19

Preeclampsia

Question 20

Preeclampsia most commonly occurs in

Answer 20

Nulliparous women in their third trimester

Question 21

Severe preeclampsia necessitates delivery at what AOG?

Answer 21

32 to 34 weeks AOG

Question 22

What is the most common medical complication of pregnancy?

Answer 22

Diabetes

Question 23

When should fetal monitoring begin in medication-controlled gestational diabetics?

Answer 23

Between 32-36 weeks AOG.

NST or modified BPP on a weekly or biweekly basis until delivery; EFW to check for fetal macrosomia between 34-37 weeks

Question 24

When should diabetes screening (75g OGTT) be done?

Answer 24

Initial prenatal visit for patients with risk factors
24-28 weeks AOG for low risk patients

*also at 6-12 weeks postpartum if GDM, to check for overt DM

Question 25

What are the obstetric complications of diabetes during pregnancy?

Answer 25

Polyhydramnios, preeclampsia/eclampsia, miscarriage, infection, postpartum hemorrhage, and cesarean delivery

Question 26

When is delivery advised in controlled diabetic patients?

Answer 26

39 weeks AOG (induction of labor, or CS if EFW >4,500g)

Question 27

What are the infections that affect the fetus?

Answer 27

Neonatal sepsis, HSV, VZV, rubella, parvovirus B19, CMV, HIV, hepatitis B and C, gonorrhea, chlamydia, syphilis, toxoplasmosis

Question 28

What is the most common precursor of neonatal sepsis?

Answer 28

Chorioamnionitis

Question 29

What is the most common congenital infection and what effect does it usually have on the fetus?

Answer 29

CMV, congenital hearing loss

Question 30

Congenital Rubella Syndrome is comprised of?

Answer 30

Deafness, congenital cataracts, CNS defects, cardiac malformations (most common PDA)

Question 31

Choriamnionitis necessitates delivery and may be diagnosed clinically. What comprises the basis for diagnosis?

Answer 31

Maternal fever, elevated maternal WBC count (>15,000/ml), uterine tenderness, maternal/fetal tachycardia, and foul-smelling amniotic fluid.

Question 32

Fetal Alcohol Syndrome includes:

Answer 32

Growth retardation, CNS effects, abnormal facies, cardiac defects

Question 33

What is the most significant neonatal complication of maternal lupus?

Answer 33

Neonatal heart block (due to production of anti-Ro (SSA) and anti-La (SSB) that are tissue-specific to the fetal cardiac conduction system).

Question 34

Postpartum hemorrhage is defined as:

Answer 34

Blood loss >500ml in NSD, or >1000ml in CS.

Early postpartum hemorrhage: first 24 hours; late postpartum hemorrhage: after 24 hours.

Question 35

What is the leading cause of postpartum hemorrhage?

Answer 35

Uterine atony