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Category: Obstetrics & Gynecology--->Obstetrical Complications of Pregnancy
Page: 1

Question 1# Print Question

A 32-year-old G2P1 at 28 weeks’ gestation presents to labor and delivery with a chief complaint of vaginal bleeding. Her vital signs are— blood pressure 115/67 mm Hg, pulse 87 beats per minute, temperature 37.0°C, respiratory rate 18 breaths per minute. She reports no contraction and states that the baby is moving normally. On ultrasound, the placenta is located on the anterior wall of the uterus, and completely covers the internal cervical os.

Which of the following would most increase her risk for hysterectomy?

A. Desire for sterilization
B. Development of disseminated intravascular coagulopathy (DIC)
C. Placenta accreta
D. Prior vaginal delivery
E. Smoking


Question 2# Print Question

A patient at 17 weeks’ gestation is diagnosed with an intrauterine fetal demise. She desires expectant management. She returns to your office 5 weeks later, and her vital signs are—blood pressure 110/72 mm Hg, pulse 93 beats per minute, temperature 36.38°C, respiratory rate 16 breaths per minute. She has not had a miscarriage, although she has had some occasional spotting. Her cervix is closed on examination.

This patient is at increased risk for which of the following?

A. Septic abortion
B. Recurrent abortion
C. Consumptive coagulopathy
D. Future infertility
E. Ectopic pregnancies


Question 3# Print Question

A 24-year-old G1P0 presents at 30 weeks’ gestation for a new OB visit. She provides you with the official report of a dating ultrasound performed at 12 weeks; however, shortly thereafter, she moved out of state and has not had prenatal care. She has no medical problems, and has a normal BMI. She reports some abdominal cramping and shortness of breath. During her visit, you examine her cervix and it is closed. You measure her fundal height at 50 cm.

What is the next best step in management?

A. Order an ultrasound
B. Tell the patient that she is most likely having twins
C. Teach her how to do fetal kick counts, and instruct her to return in 1 week
D. Tell her that her baby will be very large and recommend a caesarean delivery
E. Order a glucose tolerance test


Question 4# Print Question

A 24-year-old G1P0 presents at 30 weeks’ gestation for a new OB visit. She provides you with the official report of a dating ultrasound performed at 12 weeks; however, shortly thereafter, she moved out of state and has not had prenatal care. She has no medical problems, and has a normal BMI. She reports some abdominal cramping and shortness of breath. During her visit, you examine her cervix and it is closed. You measure her fundal height at 50 cm.

An ultrasound is performed, and demonstrates a singleton fetus with an estimated fetal weight (EFW) in the 53 percentile. The amniotic fluid index is 30 cm, consistent with a diagnosis of polyhydramnios.

How should you counsel this patient?

A. She does not require any further evaluation
B. The incidence of associated malformations is approximately 3%
C. Maternal edema, especially of the lower extremities and vulva, is rare
D. Esophageal atresia is accompanied by polyhydramnios in nearly 10% of cases
E. Potential complications include placental abruption, uterine dysfunction, and postpartum hemorrhage


Question 5# Print Question

During routine ultrasound surveillance of a twin pregnancy, twin A weighs 1200 g and twin B weighs 750 g. Polyhydramnios is noted around twin A, while twin B has oligohydramnios.

Which of the following statements correctly describes this syndrome?

A. The donor twin develops polyhydramnios more often than the recipient twin
B. Gross differences may be observed between donor and recipient placentas
C. The donor twin usually suffers from a hemolytic anemia
D. The donor twin is more likely to develop widespread thromboses
E. The donor twin often develops polycythemia




Category: Obstetrics & Gynecology--->Obstetrical Complications of Pregnancy
Page: 1 of 8