Day 6 – EMQ

A. Clomiphene citrate
B. Diagnostic hysteroscopy
C. Diagnostic hysteroscopy and diagnostic laparoscopy dye test
D. Diagnostic laparoscopy and saline test
E. HSG
F. Laparoscopy and methylene blue dye test
G. Offer insertion of cervical suture in second trimester
H. Offer insertion of prophylactic cervical suture in first trimester
I. Offer insertion of prophylactic suture in first trimester
J. Reassurance
K. Saline hysteroscopy
L. Ultrasound cervical length assessment during first and second trimesters
M. Vaginal progesterone suppositories from 13 weeks onwards

For each of the following clinical scenario, choose the most appropriate option. Each option may be used once, more than once or not at all.

1. A 35-yr old woman has had 2 previous painless miscarriages in the second trimester had normal baseline investigations. She is concerned about the risk of preterm labour.

2. A 30-yr old multiparous woman who has had 2 previous CS is being investigated for secondary infertility. She has history of pelvic infection in the past.

3. A 38-yr old nulliparous woman with primary infertility of five years’ duration has a history of irregular painful heavy periods and deep dyspareunia.

4. A 29-yr old multiparous woman with a BMI of 32 with mid-luteal progesterone of 8 nmol/L is asymptomatic.

5. A 38-yr old nulliparous woman with a BMI of 35 with regular ovulatory cycles.

A. Aspirin and LMWH
B. Assisted conception treatment
C. Cervical length assessment
D. Clindamycin cream
E. Folic acid
F. High dose steroids
G. Low dose aspirin
H. Metformin
I. Partner’s white cell infusion
J. Pre-implantation genetic diagnosis
K. Reassurance
L. Uterine reconstructive surgery
M. Weight management

For each of the following clinical scenario, choose the most appropriate option. Each option may be used once, more than once or not at all.

6. A 30-yr old woman with 3 first-trimester pregnancy losses and normal BMI has normal investigation results for recurrent miscarriage. What will management during her next pregnancy include?

7. A 37-yr old woman with 4 first-trimester pregnancy losses is thrombophilia screening test +ve on two separate occasions.

8. A 30-yr old nulliparous woman has a history of recurrent miscarriage with a BMI 40 and normal thrombophilia screening.

9. A 25-yr old woman who has had one spontaneous pregnancy loss during the second trimester.

10. A 30-yr old woman with a history of recurrent miscarriage and a normal BMI is diagnosed with an arcuate uterus.