PREMATURITY
What is the cut-off gestational age for defining extreme prematurity?
<28 wks
In which of the following scenarios, Di-Di Twin pregnancy at 36 wks, in labour, can be delivered vaginally
1) Twin 1 Breech; Twin 2 Cephalic
2) Twin 1 Oblique; Twin 2 Breech
3) Twin 1 Cephalic; Twin 2 Breech
4) Twin 1 transverse; Twin 2 Breech
3) Twin 1 Cephalic; Twin 2 Breech
Vaginal delivery is appropriate if Twin A is cephalic, with careful monitoring and preparation for possible breech extraction or cesarean for Twin B.
Proportion of L:S ratio in amniotic fluid considered appropriate for lung maturity is
a) 1:2
2) 1:4
3) 2:1
4) 4:1
3) 2:1
A 32-year-old primigravida at 36 weeks presents with severe preeclampsia. She is hypertensive, has proteinuria, and complaints of persistent headache. What is the first-line medication to prevent seizures in this patient?
A. Labetalol
B. Magnesium sulfate
C. Hydralazine
D. Nifedipine
B. Magnesium sulfate
Which of the following is a potential advantage of delayed cord clamping in preterm neonates?
A. Reduced risk of necrotizing enterocolitis
B. Improved hematocrit levels
C. Lower incidence of intraventricular hemorrhage
D. All of the above
D. All of the above
Optimal timing of delivering a woman with Dichorionic Diamniotic twins
1) Elective delivery at 35 weeks
2) Elective delivery at 36 weeks
3) Elective delivery at 37 weeks
4) Spontaneous - self progressing
3) Elective delivery is recommended at 37 weeks in uncomplicated dichorionic diamniotic twins
Q: What is the name of the test used to detect fetal hemoglobin in maternal circulation?
Kleihauer-Betke test
What is the preferred treatment modality for Stage II or higher TTTS in monochorionic-diamniotic twins?
A. Amnioreduction
B. Laser photocoagulation
C. Fetal transfusion
D. Selective termination
B. Laser photocoagulation of placental anastomoses
Incidence of respiratory distress syndrome increases with all of the following Except
1.Prematurity
2.Maternal diabetes
3.Black race
4.Male gender
5.Cesarean section delivery
Black race
A 30-year-old G1 at 16 weeks is diagnosed with a monochorionic diamniotic twin pregnancy. What is the recommended frequency of ultrasounds to monitor for complications?
1) EVERY 2 WEEKS STARTING AT 16 WKS
2) EVERY 4 WEEKS STARTING AT 16 WKS
3) EVERY 4 WEEKS STARTING AT 20 WKS
4) JUST LIKE ROUTINE
1) Every 2 weeks starting at 16 weeks to monitor for TTTS and growth discrepancies
polycythemia exists when the hct value is greater than
a) 55
b) 60
c) 65
d) 70
c) 65
A fetus at 30 weeks with severe anemia secondary to Rh isoimmunization is undergoing intrauterine transfusion. What is the preferred site for transfusion?
A. Umbilical vein at the placental insertion
B. Fetal hepatic vein
C. Fetal femoral vein
D. Umbilical artery at the cord insertion
A. Umbilical vein at the placental insertion
Which of the following tocolytics has the most favorable safety profile for prolonging pregnancy beyond 34 weeks?
A. Nifedipine
B. Atosiban
C. Indomethacin
D. Terbutaline
A. Nifedipine
Fetal Fibronectin (FFN) is used for
1) Asssessment of fetal growth and maturity
2) As a fetal stress-biomarker
3) Prediction of premature labour
4) Management of preterm labour
Prediction of Premature labour
In comparison to Singleton pregnancies, Dose of A/N Steroids in Twin pregnancy is
1) Double
2) 1.5 times
3) Same
4) Same if Monochorionic but Double if Dichorionic
3) Same
What is the threshold serum magnesium level above which toxicity can occur in a pregnant patient receiving magnesium sulfate?
a) 3.5mg/dl
b) 8mg/dl
c) 13mg/dl
d) 25mg/dl
8 MG/DL
Which of the following is the most innovative approach for managing Placenta Accreta Spectrum to minimize maternal morbidity?
A. Hysterectomy
B. Methotrexate therapy
C. Uterine artery embolization
D. Conservative management with delayed placental delivery
C. Uterine artery embolization
Which intervention shows potential for improving placental blood flow in cases of FGR?
A. Sildenafil citrate
B. Low-dose aspirin
C. Antioxidant therapy
D. Heparin
A. Sildenafil citrate
Contraindications to delaying preterm labor with tocolytics, include all EXCEPT?
1) Maternal Age>35 yrs
2) Severe preeclampsia or eclampsia
3) Intrauterine infection (chorioamnionitis)
4) Placental abruption
Maternal Age>35 yrs
A 34-year-old G3P2 at 28 weeks with monochorionic diamniotic twins presents with acute abdominal pain and hypotension. Ultrasound shows absent end-diastolic flow in the umbilical artery of one twin. What condition should you suspect?
1) Twin-Twin Transfusion
syndrome (TTTS)
2) Twin Anemia-Polycythemia Sequence (TAPS)
3) Twin Reverse Arterial Perfusion (TRAP)
4) DIC
2) Twin Anemia-Polycythemia Sequence (TAPS)
What is the normal range of follicle-stimulating hormone (FSH) in women during the follicular phase of the menstrual cycle?
A: 0.2-2 IU/L
B. 3–10 IU/L
C. 15-50 IU/L
D. 75-100 IU/L
B. 3–10 IU/L
Studies have shown the maternal microbiome may influence pregnancy outcomes. Which of the following interventions is under investigation to modify the microbiome for better outcomes?
A. Probiotics
B. Prebiotics
C. Fecal microbiota transplantation (FMT)
D. All of the above
D. All of the above
Which of the following is a cutting-edge non-invasive approach to monitor fetal well-being in high-risk pregnancies?
A. Fetal ECG via maternal abdominal electrodes
B. Continuous fetal oxygen saturation monitoring with ultrasound probes
C. Real-time placental perfusion imaging using near-infrared spectroscopy (NIRS)
D. Doppler velocimetry of all umbilical vessels simultaneously
A. Fetal ECG via maternal abdominal electrodes