EBCOG Part-1 High Yield questions – Post OP Care (S.B.A)

1.Which of the following statement best describes perinatal mortality?

2.  From the list of following drugs which one should be avoided during breastfeeding

3.Regarding maternal mortality, which of the following is incorrect?

4. A patient is referred to the gynaecology clinic for consideration of hysterectomy following a failed endometrial ablation.At what point should enhanced recovery planning start?

5. A woman has had a successful trial of forceps delivery under spinal anaesthetic. What is the minimum duration that the catheter should remain in situ to reduce the risk of asymptomatic bladder overfilling?

 6.A 48-year-old woman has undergone a midurethral tape procedure for stress urinary incontinence and is ready to be discharged. Within what time frame should she be seen as an outpatient to exclude tape erosion?

7.A patient is seen 2 weeks after a laparoscopic hysterectomy. An intraoperative bladder injury was noted and repaired laparoscopically by the urologist. A catheter has been left in situ for 2 weeks. A retrograde cystogram subsequently reports a leak from the bladder. The woman is clinically well. What is the most appropriate management?

8. A 38-year-old woman is admitted with nausea, vomiting and confusion following a transcervical resection of the endometrium (TCRE) for heavy menstrual bleeding. It is noted that the fluid deficit at the time of the procedure was 1.6 l. What is the single most important investigation?

9. A 49-year-old woman had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for irregular menstrual bleeding and pelvic pain, related to previous diagnosis of endometriosis. Her immediate postoperative recovery was uneventful. Seven days later, she is readmitted with a vaginal loss of watery fluid and blood- stained urine.What is the most likely diagnosis?

10. Following surgery, how long should patients wait before they can shower?

11.What is the most common type of postoperative infection following an emergency caesarean section?

12.Of women that develop pyrexia in the first 48 hours after gynaecological surgery,what proportion do not have an identifiable cause?

13. Following a general anaesthetic, what is the most common cause of pyrexia in the immediate postoperative period?

14. A 27-year-old primigravida presents at 35+3 weeks’ gestation with a headache and 24 hours of no fetal movement. An IUFD and preeclampsia  are diagnosed. Induction of labour is performed. Four days a er delivery  her BP is still very labile, and she continues to require second-line oral  therapy. She is troubled by lactation and breast pain. What would be the best management for her?

15. A 23-year-old medical student has delivered a healthy male neonate weighing 2900 g at term 36 hours ago by SVD. T e mother is generally t  and well and has been granted a year out of her studies, having found out she was pregnant shortly a er her elective in Papua New Guinea. She has noticed that, this morning, the neonate has rapidly developed severe bilateral conjunctivitis with a profuse purulent discharge. Last night the  neonate’s eyes looked normal.What is the most likely causative organism in this case of neonatal conjunctivitis?

16.A 32-year-old primigravida commences a planned delivery in a rural  stand-alone midwifery unit. A er 8 hours of established labour, the second stage of labour is diagnosed. T e woman develops an urge to push 1 hour later and she commences pushing. A er 30 minutes late decelerations are heard on intermittent auscultation. On examination the fetus is cephalic, 2/5 palpable per abdomen, fully dilated, direct OP and at station spines −1. T ere is 3+ caput and 3+ moulding. A decision is made for transfer to hospital, although this is delayed because of treacherous snow-covered and ice-covered roads. On arrival at  hospital 3 hours later the C G is severely abnormal, with examination ndings unchanged and a category 1 caesarean section is performed. en minutes a er delivery resuscitation is stopped for a few seconds while the neonate is reassessed. T e fetus is still extremely oppy, with no pulse, no response to stimulation and no spontaneous breathing. It is blue.What is the infant’s 10-minute Apgar score?

17. A 32-year-old obese primigravida has a forceps delivery at 39+2 weeks’ gestation for suspected fetal compromise. Because the baby is not spontaneously crying at delivery, the obstetrician clamps and cuts the cord immediately. Shortly a erwards, however, the baby spontaneously cries a er stimulation by the midwife. T e following day the baby feeds
poorly and is found to be anaemic. T e issue of cord clamping in term neonates is discussed and debated between the obstetricians and neonatologists at the next perinatal morbidity meeting. What is the best management regarding cord clamping in term neonates?

18.  A healthy 34-year-old low-risk primigravida is referred to the obstetric antenatal clinic by her midwife at the woman’s request to discuss the management of the third stage of labour. Her antenatal group has advised her to have physiological management of the third stage of labour to improve bonding with her baby. T ey suggest that, as long as
she delivers in a quiet room, her own endogenous oxytocin will work well and, as she is ‘low risk’; her chance of postpartum haemorrhage will be no higher than if she were to have an active management of the third stage. T e woman asks you for your advice and rationale for this regarding management of her third stage of labour.
Which is the best advice?

19. A 32-year-old low-risk primigravida presents with contractions at 26+0 weeks’ gestation. On examination the cervix is 5 cm dilated. She is admitted, steroids are given and a magnesium sulphate infusion is commenced. She is anxious and is keen to know a very approximate prognosis for her fetus. Approximately what percentage of live births at 26 weeks’ gestation will go on to survive without disability?

20. A 33-year-old primigravida with asthma delivers a live infant at term. T ere was no meconium. T e infant makes no spontaneous attempt at breathing and is oppy. It is dried, covered and assessed. Five in ation breaths are performed. T ere is good chest movement on in ation. T e neonate is then reassessed: there is a heart rate of around 50 bpm
although still no breathing. Senior assistance is summoned and en route. What is the next immediate step?