EBCOG Part 1 – High Yield Questions – Antenatal care(S.B.A)

1. A 30-year-old woman with a previous history of caesarean section and multiple uterine fibroids had a repeat elective caesarean section due to breech presentation. She had massive postpartum haemorrhage (PPH) secondary to uterine atony with an estimated blood loss of 3 L. She is RhD-negative and had transfusion of the group specific packed red cells, reinfusion of the salvaged red cells from the cell saver and also fresh frozen plasma (FFP), cryoprecipitate and platelets. The cord blood group was confirmed as RhD-negative. Anti-D prophylaxis should be administered in which one of the options,if she had the following blood products transfused?

2. A 20-year-old, nulliparous woman at 12 weeks’ gestation attends her antenatal booking appointment. Which one of the following questionnaires was recommended to assess the mental health and well-being of the woman?

3. A 28-year-old para 1 woman with history of bipolar disorder and previous postpartum psychosis attends her antenatal clinic appointment at 14 weeks’ gestation.What is her risk of developing postpartum psychosis?

4. A 30-year-old nulliparous woman was treated for an early stage breast cancer 2 years ago and is currently taking tamoxifen. She wishes to conceive and attends clinic for your advice. Which one of the statements is most appropriate?

5. A 28-year-old nulliparous woman was diagnosed with an early stage breast cancer at 12 weeks of pregnancy.Her case was reviewed by the multidisciplinary team. What is likely to be their recommendation?

6. A 28-year-old teacher was given varicella-zoster immunoglobulin G (VZIG) after a significant exposure to chickenpox at 24 weeks’ gestation, as she was found to be seronegative on her booking bloods.How long should she be considered potentially infectious after exposure tochickenpox?

7. A para 2, HIV-positive woman with low viral load and two previous normal vaginal deliveries was planning to have a vaginal delivery. She attends antenatal clinic at 28 weeks’ gestation and says that she had a recurrence of genital herpes 2 weeks ago, which has now resolved.  From what gestation would you advise her to take prophylactic daily suppressive acyclovir to reduce the risk of HIV transmission to the foetus?

8.A nulliparous woman at 35 weeks’ gestation develops primary genital herpes and an elective caesarean section was recommended by your consultant to reduce the risk of neonatal transmission of herpes simplex virus (HSV) at birth. What is the neonatal HSV transmission at birth?

9. A para 1 woman at 33 weeks’ gestation presents with preterm premature rupture of membranes (PPROM). She had a recurrence of genital herpes 3 days ago. On examination PPROM was confirmed, and the genital lesions are healing .What is the most appropriate management option?

10.A 42-year-old, para 4 woman with pre-eclampsia comes to antenatal clinic at 34 weeks’ gestation. She is asymptomatic with stable blood pressures on labetalol and the biochemical markers are normal. Growth scan confirmed foetal growth restriction. She is extremely anxious as she had abruption in her previous pregnancy that has led to an emergency caesarean section at 34 weeks’ gestation.  Which one of the risk factors has the most predictive value for abruption in this pregnancy?

11. A 38-year-old para 3 woman with three previous caesarean sections has attended her first antenatal clinic appointment. What is her risk for placenta praevia in comparison to women with no previous caesarean sections?

12. A gravida 4 para 2 woman attends at 32 weeks’ gestation with history of ruptured membranes. She had cervical cerclage placed at 13 weeks’ gestation because of two previous preterm deliveries and one second trimester loss. She is well in herself with no signs of infection, not contracting, CTG is normal and PPROM is confirmed on examination. Scan confirmed normal growth, liquor and Doppler. Which one of the statements is true with regards to the timing of suture removal?

 13.A nulliparous woman was referred to the day assessment unit after an incidental finding of a cervical length of 18 mm with funnelling at 23 weeks’ gestation by the sonographer. On speculum examination, no bulging membranes were seen. She had no previous cervical trauma or preterm deliveries.What is the most appropriate step?

14. A 25-year-old woman in her first pregnancy is seen at 40 weeks 5 days for a routine check. You are asked to counsel her about induction of labour. Which of the following statements is correct?

15. Which of the following lung function tests remains unchanged during pregnancy?

16. A healthy 24-year-old woman in her first pregnancy is admitted at 29 weeks’ gestation with confirmed preterm, prelabour rupture of membranes. What is the next course of action? 

17. Induction of labour is recommended beyond 41 weeks’ gestation.Of the following the most important reason for inducing labour beyond 41 weeks is: 

 18. Of the following vaccines, which one should be avoided during pregnancy?

19.  Maternal intravenous immunoglobulin (IVIG) is now the first line treatment for one of the following: 

20. With regards to parvovirus, which of the following is correct?