EBCOG Part 1 Antenatal Care summary EMQ

EMQ :

Options for questions 1–5

A.10 + 0 weeks

B.12 + 0 weeks

C.14 + 0 weeks

D.16 + 0 weeks

E.18 + 0 weeks

F.20 + 0 weeks

G.24 + 0 weeks

H.28 + 0 weeks

I.32 + 0 weeks

J.34 + 0 weeks

K35 + 0 weeks

L.36 + 0 weeks

M.37 + 0 weeks

N.38 + 0 weeks

O.39 + 0 weeks

For each of the following clinical scenarios pertaining to multiple pregnancy, choose the single most appropriate gestational age from the list above. Each option may be used more than once, more than once or not at all.

1. A 24-year-old woman is referred to the antenatal clinic. She is uncertain of her last menstrual period and is thought to be in the second trimester. An ultrasound scan shows a twin pregnancy. Ideally, by what gestational age should chorionicity have been determined?

2.A 34-year-old woman is found in the first trimester to have an MCDA twin pregnancy. From what gestational age should serial ultrasound scans commence?

3. A 30-year-old woman is found in the first trimester to have a DCDA twin pregnancy. From what gestational age should serial assessment of fetal weight commence?

4. A 25-year-old woman is seen in the antenatal clinic with a DCDA twin pregnancy. It has so far been uncomplicated. From what gestational age should delivery be offered if it remains uncomplicated?

5. A 38-year-old woman is known to have an uncomplicated triplet pregnancy following IVF. From what gestational age should delivery be offered?

Options for questions 6–9

A.Antenatal booking blood tests including hepatitis C screen

B.Antenatal care by consultant obstetrician

C.Clitoral reconstruction

D.Immediate deinfibulation procedure

E.Immediate risk assessment about child safeguarding

F.Inform the police or social services

G.Intrapartum deinfibulation

H.Midwife-led antenatal care

I.Refer to mental health services

J.Refer to safeguarding midwife

K.Review in the presence of a professional interpreter

L.Thorough examination of the genitalia

Each of the following clinical scenarios relates to a woman with FGM in pregnancy.

For each patient, select the single most appropriate advice about the next step in management from the list above. Each option may be used once, more than once or not at all.

6. A 22-year-old married British woman of Somali origin attends the consultant

antenatal clinic following her routine fetal anomaly scan. She gives a history of

having undergone FGM as a young girl at the age of 12 years and suffers from

lack of sensation during sexual intercourse. Her 5-year-old son was born via

uncomplicated vaginal birth and lives with the woman and her husband.

7. A 19-year-old woman in her first pregnancy is a new arrival in the UK. She

attends the early pregnancy unit complaining of lower abdominal pain and

vaginal spotting during the past week. There is no bleeding at present. Her home

pregnancy test was positive a few weeks ago. She has not yet registered with a GP

and does not have a community midwife. A female friend is accompanying her

and reveals that the woman had undergone a procedure suggestive of FGM in her

early childhood in Africa.

8. A 29-year-old woman in her first pregnancy at 40 weeks of gestation attends the

obstetric day assessment unit following a fall onto her abdomen. She has been booked in another hospital and is currently a visitor on holiday in the locality. She gives a history of FGM for which she was to undergo a deinfibulation procedure at 38 weeks of gestation in the hospital where she is booked but was unable to attend. She is not keen on undergoing an examination of her genitalia and wishes to deliver in her own hospital. An abdominal examination and CTG are normal.

9. An obstetric registrar is asked to review a woman in the hospital accident and emergency department with a history of amenorrhoea for 2 months complaining

of acute-onset lower abdominal pain. On questioning, she reveals that she was forced to undergo FGM a week ago. Examination reveals a remarkably distended

bladder and evidence of freshly healing vulvar wounds.