12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg.

rtile egg. Perinatal infection…

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Question 1
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A 30-year-old patient presents to your office at term with no prenatal care. An ultrasound is performed and shows the fetus to have multiple
congenital anomalies, including microcephaly, cardiac anomalies, and growth retardation. You should question the patient if she has abused
which of the following substances during her pregnancy?

a. Alcohol
b. Methadone
c. NSAIDs
d. Benzodiazepines
e. Heroin

Question 2
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Which of the signs on the cardiotachogram, listed below is not a sign of fetal hypoxia:

a. Bradycardia
b. Reducing heart rate variability
c. Accelerations
d. Monotonous fetal heart rate
e. Late decelerations

Question 3
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Causes of placental insufficiency

a. Low blood sugar, hypertension, smoking, anemia

b. Diabetes, hypertension, low body temperature
c. Chronic high blood pressure, powerless labor, low body temperature
d. Hypertension, smoking, low body temperature
e. Diabetes, hypertension, smoking, anemia

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 4

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What can be the causes of acute fetal distress during pregnancy?

a. Systemic fetal diseases

b. Detachment of the normally located placenta
c. Low placental attachment
d. Smoking
e. Hemolytic disease of the fetus

Question 5
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Examination method that poses the least risk to the fetus:

a. Doppler ultrasound
b. Cordocentesis
c. Amniocentesis
d. Chorionic villi biopsy
e. Amnioscopy

Question 6
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Chose the method of delivery in G2P1 with fetal distress in the second period of delivery.
Longitudinal lie, head presentation.

a. Reduction of the second period by episiotomy

b. Applying skinhead forceps to speed up the expulsion period
c. Cesarean section.
d. Reduction of the second period by applying obstetric forceps
e. Reduction of the second period by perineotomy

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 7

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What is the maximum fetal score on the Apgar scale?

a. 9 points
b. 2 points
c. 5 points
d. 1 point
e. 10 points

Question 8
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A 19-year-old patient, pregnancy I, at term 37-38 weeks, not in labor, was seen at the OPD for decreased
fetal movement. She was hooked to an electronic fetal monitor and tracing showed: Baseline FHT-
140’s, good variability, with more than 2 accelerations of 20 bpm lasting for 20 secs. The tracing
is interpreted as

a. Negative
b. Positive
c. Unclear
d. Reactive
e. Non-reactive

Question 9
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A 30-year-old pregnant woman was hospitalized at the department of Pathology of Pregnancy at 34

weeks. Pregnancy is complicated by a threatened abortion. The height of the fundus of the uterus is
28 cm. The uterus is in normotonus, the head presentation of the fetus. Ultrasound revealed a
biparietal head size of 30 weeks. Thigh length - 30 weeks; abdominal circumference - for 30 weeks.
What methods should be used to clarify the diagnosis?

a. Cardiotachography (stress test)

b. Ultrasound in dynamics. Cardiotachography. Doppler
c. Ultrasound in a week
d. Estriol and placental blood lactogen
e. Determination of the estimated weight of the fetus

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 10

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A 23-year-old pregnant woman presents for a routine obstetric (OB) visit at 34 weeks. She reports a history of genital herpes for 5 years. She
reports that she has had only two outbreaks during the pregnancy, but is very concerned about the possibility of transmitting this infection to
her baby. Which of the following statements is accurate regarding how this patient should be counseled?

a. The patient should be scheduled for an elective cesarean section at 39 weeks of gestation to
avoid neonatal infection
b. Starting at 36 weeks, weekly genital herpes cultures should be done
c. Suppressive antiviral therapy can be started at 36 weeks to help prevent an outbreak
from occurring at the time of delivery
d. The herpes virus is commonly transmitted across the placenta in a patient with a history of herpes
e. There is no risk of neonatal infection during a vaginal delivery if no lesions are present at the
time the patient goes into labor

Question 11
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The first labor at term. Preterm rupture of the membranes has occurred. Primary powerless labor,
stimulation by oxytocin. The first period of the labor has already continued for 10 hours. Fetal
heartbeats are damped, frequently to 90-100 beats per min. Cardiac irregularity with the passage of
meconium appears. What is the doctor’s tactics?

a. To continue the observation

b. To perform the oxygenation
c. To continue the stimulation by oxytocin
d. To perform Cesarean section
e. To apply the obstetric forceps

Question 12
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A 26-year-old G1P0 patient at 34 weeks gestation is being evaluated with Doppler ultrasound
studies of the fetal umbilical arteries. The patient is a healthy smoker. Her fetus has shown evidence
of intrauterine growth restriction (IUGR) on previous ultrasound examinations. The Doppler studies
currently show that the systolic to the diastolic ratio (S/D) in the umbilical arteries is much higher than
it was on her last ultrasound 3 weeks ago and there is now reverse diastolic flow. Which of the
following is the correct information to share with the patient?

a. The Doppler studies are worrisome and indicate that the fetal status is deteriorating
b. Reverse diastolic flow is normal as a patient approaches full term
c. With advancing gestational age the S/D ratio is supposed to rise
d. The Doppler studies indicate that the fetus is doing well
e. These Doppler findings are normal in someone who smokes

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 13

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The boy was born from the first pregnancy, the first vaginal birth in a gestation term of 40 weeks (weight 3250 g, length of the rear 52 cm). A
18-year-old mother is HIV positive. The child's birth condition is satisfactory. Is it possible to get BCG vaccination for this baby?

a. Do not vaccinate in any case

b. After clarifying the child's HIV status
c. On the 3rd day
d. After the Mantoux test
e. On the 1st day

Question 14
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An infant has been born at the 41st week of gestation. The pregnancy was complicated with severe
gestosis. The weight of the baby is 2400 g, and the height is 49 cm. Objectively: the skin is flabby, the
layer of subcutaneous fat is thin, hypotonia, and neonatal reflexes are weak. The internal organs are
without pathologic changes. This newborn can be assessed as a:

a. Postmature infant
b. Full-term infant with normal body weight
c. Immature infant
d. Premature infant
e. Full-term infant with intrauterine growth retardation

Question 15

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The first labor at term in a 23-year-old patient, the 2nd period. Secondary weakness of uterine
The activity was stimulated by oxytocin. The expulsive period of labor has already continued for 2 hours.
Fetal condition assessment revealed: that fetal heartbeats are damped, frequently to 80-90 beats per
min. According to the vaginal examination: the uterine cervix is fully dilated, fetal head engages in
the narrow part of the pelvis, sagittal suture is in the right oblique diameter, fetal membranes are
absent. What is the diagnosis? What tactics will you choose?

a. Cesarean section
b. Observation
c. Vacuum-extraction
d. Application of the mid obstetric forceps
e. Application of the low obstetric forceps

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 16

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What is not included in IUGR diagnostic criteria?

a. Conducting a biophysical profile of the fetus

b. Registration of fetal heart rate
c. X-ray examination
d. Doppler ultrasound
e. Ultrasound fetobiometry

Question 17
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The most objective method for assessing fetal distress during delivery is:

a. Counting the number of fetal movements

b. Auscultation
c. Ultrasound
d. Determination of pH of blood taken from the anterior part of the fetus
e. Cardiotocography

Question 18
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A 33-year-old woman at 9 weeks of pregnancy II- hospitalization in the department of extragenital pathology. I pregnancy- the baby was
born with a mass of 4100 gr. What examination should be done first?

a. Phonocardiography of the fetus

b. Ultrasound of the fetus
c. Determination of the content of alpha-fetoprotein
d. Bacteriological examination is possible from the vagina
e. Test for glucose tolerance

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12/29/22, 2:51 AM Prenatal care.Placental dysfunction, delay in fetal development, fetal dystress. Abnormalities of the fertile egg. Perinatal infection…

Question 19

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The most common cause of placental insufficiency is

a. Proteinuria
b. Anemia
c. Preeclampsia
d. Kidney disease
e. Obesity

Question 20
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A healthy 40-year-old multiparous patient has been admitted to the antenatal clinic for preconception counseling. She is extremely worried
about her risk of having a baby with spina bifida. Five years ago, this patient delivered a baby with anencephaly who died shortly after birth.
What is the most appropriate counsel for this woman regarding future pregnancies?

a. She does not have a recurrence risk of a neural tube defect above that of the general population
b. When she becomes pregnant, she should undergo diagnostic testing for fetal neural tube defects with a first-trimester CVS
c. When she becomes pregnant, she should avoid hyperthermia in the first trimester because both maternal fevers and the use of hot
tubs have been associated with an increased risk of neural tube defects
d. She has an increased risk of having another baby with anencephaly because she is more than 35 years old
e. She has a recurrence risk of having another baby with a neural tube defect of less than 1%

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