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

Question 36#Print Question

A 27-year-old G2P1 at 29 weeks’ gestation who is being followed for Rh isoimmunization presents for her OB visit. The fundal height is noted to be 33 cm. An ultrasound reveals fetal ascites and a pericardial effusion.

Which of the following can be another finding in fetal hydrops?

a. Oligohydramnios
b. Hydrocephalus
c. Hydronephrosis
d. Subcutaneous edema
e. Over-distended fetal bladder


Question 37#Print Question

A 39-year-old G2P1001 at 39 weeks’ gestational age is sent to labor and delivery from her obstetrician’s office because of a blood pressure reading of 150/100 mm Hg obtained during a routine OB visit. Her baseline blood pressures during the pregnancy were 100 to 120/60 mm Hg to 70 mm Hg. On arrival to labor and delivery, the patient reports no headache, visual changes, nausea, vomiting, or abdominal pain. The heart rate strip is reactive and the tocodynamometer shows irregular uterine contractions. The patient’s cervix is 3 cm dilated. Her repeat blood pressure is 160/90 mm Hg. Hematocrit is 34.0%, platelets are 90,000 mL, SGOT is 22 units per liter, SGPT is 15 units per liter, and urinalysis is negative for protein.

Which of the following is the most correct diagnosis?

a. Preeclampsia
b. Preeclampsia with severe features
c. Chronic hypertension with superimposed preeclampsia
d. Eclampsia
e. Gestational hypertension


Question 38#Print Question

A 39-year-old G2P1001 at 39 weeks’ gestational age is sent to labor and delivery from her obstetrician’s office because of a blood pressure reading of 150/100 mm Hg obtained during a routine OB visit. Her baseline blood pressures during the pregnancy were 100 to 120/60 mm Hg to 70 mm Hg. On arrival to labor and delivery, the patient reports no headache, visual changes, nausea, vomiting, or abdominal pain. The heart rate strip is reactive and the tocodynamometer shows irregular uterine contractions. The patient’s cervix is 3 cm dilated. Her repeat blood pressure is 160/90 mm Hg. Hematocrit is 34.0%, platelets are 90,000 mL, SGOT is 22 units per liter, SGPT is 15 units per liter, and urinalysis is negative for protein. 

While being evaluated in triage, she is noted to have tonic-clonic seizure.

Which of the following is the next step in the management of this patient?

a. Low-dose aspirin
b. Dilantin (phenytoin)
c. Antihypertensive therapy
d. Magnesium sulfate
e. Cesarean delivery


Question 39#Print Question

A 39-year-old G2P1001 at 39 weeks’ gestational age is sent to labor and delivery from her obstetrician’s office because of a blood pressure reading of 150/100 mm Hg obtained during a routine OB visit. Her baseline blood pressures during the pregnancy were 100 to 120/60 mm Hg to 70 mm Hg. On arrival to labor and delivery, the patient reports no headache, visual changes, nausea, vomiting, or abdominal pain. The heart rate strip is reactive and the tocodynamometer shows irregular uterine contractions. The patient’s cervix is 3 cm dilated. Her repeat blood pressure is 160/90 mm Hg. Hematocrit is 34.0%, platelets are 90,000 mL, SGOT is 22 units per liter, SGPT is 15 units per liter, and urinalysis is negative for protein. 

The decision is made to deliver the patient promptly.

Which factors will help you determine the best mode of delivery?

a. The patient has advanced maternal age, and therefore must be delivered by cesarean immediately
b. The patient’s cervix is 3 cm dilated, and therefore must undergo induction of labor
c. The patient has low platelets, so she must undergo induction of labor because surgery could cause significant hemorrhage
d. The patient had a seizure, and therefore must be delivered immediate by cesarean
e. The patient is a candidate for labor induction or cesarean delivery if the fetal and maternal status are reassuring after her seizure


Question 40#Print Question

A 39-year-old G2P1001 at 39 weeks’ gestational age is sent to labor and delivery from her obstetrician’s office because of a blood pressure reading of 150/100 mm Hg obtained during a routine OB visit. Her baseline blood pressures during the pregnancy were 100 to 120/60 mm Hg to 70 mm Hg. On arrival to labor and delivery, the patient reports no headache, visual changes, nausea, vomiting, or abdominal pain. The heart rate strip is reactive and the tocodynamometer shows irregular uterine contractions. The patient’s cervix is 3 cm dilated. Her repeat blood pressure is 160/90 mm Hg. Hematocrit is 34.0%, platelets are 90,000 mL, SGOT is 22 units per liter, SGPT is 15 units per liter, and urinalysis is negative for protein.

The patient is successfully inducted and undergoes vaginal delivery. Postpartum, she is on magnesium sulfate for seizure prophylaxis. Her vital signs are—blood pressure 154/98 mm Hg, pulse 93 beats per minute, respiratory rate 24 breaths per minute, and temperature 37.3°C. She has adequate urine output at greater than 40 cc/h. On examination, she is oriented to time and place, but she is somnolent and her speech is slurred. She has good movement and strength of her extremities, but her deep tendon reflexes are absent.

Which of the following is the most likely cause of her symptoms?

a. Adverse reaction to hydralazine
b. Hypertensive stroke
c. Magnesium toxicity
d. Sinus venous thrombosis
e. Transient ischemic attack




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