Self Assessment: Obstetrics Quiz
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Self Assessment: Obstetrics Quiz

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Questions and Answers

Blighted ovum is:

  • Synaptic knobs
  • Avascular villi
  • Intervillous hemorrhage
  • None of the above (correct)

    • The most life-threatening complications of septic abortion include:

  • Peritonitis
  • Septicemia (correct)
  • Respiratory distress syndrome
  • Renal failure

    • The method most suitable for MTP in the 3rd month of pregnancy is:

  • Suction and evacuation (correct)
  • Extra amniotic ethacridine
  • Hysterectomy
  • Dilatation and curettage

    • The best method of evacuation of a missed abortion in the uterus of more than 12 weeks:

    <p>Prostaglandin E1 vaginal misoprostol followed by evacuation of the uterus</p> Signup and view all the answers

    Pregnancy which continues following threatened abortion is likely to have increased incidence of:

    <p>All of the above</p> Signup and view all the answers

    Suction evacuation can be done up to:

    <p>10 weeks</p> Signup and view all the answers

    What is the next best step for a female with amenorrhea of 5 weeks and no fetal pole or cardiac activity visible?

    <p>High probability of nonviable pregnancy but still repeat scan after 7 days to confirm</p> Signup and view all the answers

    The figure shows a Karman cannula. The number of cannula corresponds to:

    <p>Diameter of cannula in mm</p> Signup and view all the answers

    Identify the instrument:

    <p>Allis tissue forceps</p> Signup and view all the answers

    Levels of progesterone indicating unviable pregnancy and viable intrauterine pregnancy are:

    <p>10 ng/mL; 50 ng/mL</p> Signup and view all the answers

    Best method for MTP in 2nd trimester abortion:

    <p>Prostaglandin</p> Signup and view all the answers

    In case of recurrent abortions, the most common uterine malformation seen is:

    <p>Mullerian fusion defects</p> Signup and view all the answers

    Most common cause of first trimester abortion is:

    <p>Chromosomal abnormalities</p> Signup and view all the answers

    Commonest cause of first trimester abortion is:

    <p>Aneuploidy</p> Signup and view all the answers

    A lady has recurrent abortions in the 1st trimester with a history of autosomal recessive disorder in the family. The true statement regarding this is:

    <p>All are correct</p> Signup and view all the answers

    Spontaneous abortion in the 1st trimester is caused by:

    <p>Trisomy 21</p> Signup and view all the answers

    MC cause of abortion in the first trimester is defect in:

    <p>Embryo</p> Signup and view all the answers

    Recurrent abortion in the 1st trimester is most often due to:

    <p>Chromosomal abnormalities</p> Signup and view all the answers

    Recurrent spontaneous abortions are seen in all except:

    <p>None of the above</p> Signup and view all the answers

    All of the following are known causes of recurrent abortion except:

    <p>Rh-incompatibility</p> Signup and view all the answers

    A 26-year-old lady with a history of recurrent abortion. Which of the following investigations will you do to confirm the diagnosis?

    <p>Anti-Russell viper venom antibodies</p> Signup and view all the answers

    In a case of recurrent spontaneous abortion, the following investigation is unwanted:

    <p>Testing for TORCH infections</p> Signup and view all the answers

    A lady presented with a history of recurrent early pregnancy loss. What investigations should be ordered?

    <p>VDRL</p> Signup and view all the answers

    A woman with 20 weeks pregnant presents with bleeding per vaginum. On examination, the os is open but no products have come out. The diagnosis is:

    <p>Inevitable abortion</p> Signup and view all the answers

    A 25-year-old female reports with a history of amenorrhea for two and a half months and abdominal pain and bleeding per vaginum. What's the most likely diagnosis?

    <p>Threatened abortion</p> Signup and view all the answers

    A woman with a history of recurrent abortions presents with an isolated increase in APTT. The most likely cause is:

    <p>Lupus anticoagulant</p> Signup and view all the answers

    Anti phospholipid syndrome (APS) is associated with all of the following except:

    <p>Pancytopenia</p> Signup and view all the answers

    All of the following are true about the lupus anticoagulants except:

    <p>Severe life-threatening hemorrhage</p> Signup and view all the answers

    Cervical incompetence is characterized by:

    <p>2nd trimester abortion</p> Signup and view all the answers

    In cervical incompetence, which encirclage operation is done:

    <p>McDonald operation</p> Signup and view all the answers

    A gravida 3 female with history of 2 previous 2nd trimester abortions presents at 22 weeks of gestation with funneling of cervix and length of cervix 20 mm. What is the most appropriate management?

    <p>Apply McDonald stitch</p> Signup and view all the answers

    McDonald stitch is applied in the following conditions except:

    <p>Placenta previa</p> Signup and view all the answers

    A 28-year-old female with a history of 8 weeks amenorrhea complains of vaginal bleeding and lower abdominal pain. On USG examination, there is a gestational sac with absent fetal parts. The diagnosis is:

    <p>Incarcerated abortion</p> Signup and view all the answers

    Antiprogesterone compound RU-486 is effective for inducing abortion if the duration of pregnancy is:

    <p>88 days</p> Signup and view all the answers

    All of the following drugs have been used for medical abortion except:

    <p>Atosiban</p> Signup and view all the answers

    In extra amniotic 2nd trimester medicolegal termination of pregnancy, which of the following is used?

    <p>Hypertonic saline</p> Signup and view all the answers

    According to MTP Act, 2 doctor's opinion is required when pregnancy is:

    <blockquote> <p>12 weeks</p> </blockquote> Signup and view all the answers

    For medical termination of pregnancy, consent should be obtained from:

    <p>The female partner</p> Signup and view all the answers

    Mifepristone is not used in:

    <p>Ectopic pregnancy</p> Signup and view all the answers

    A G6+0+0 lady with a history of recurrent missed abortions at 14-16 weeks comes to you with a missed abortion at 12 weeks. Which of the following tests is not warranted?

    <p>VDRL of father and mother</p> Signup and view all the answers

    Absolute contraindications for medical abortion include:

    <p>Suspected ectopic pregnancy</p> Signup and view all the answers

    Blighted ovum is:

    <p>Avascular villi</p> Signup and view all the answers

    The most life-threatening complications of septic abortion includes:

    <p>Respiratory distress syndrome</p> Signup and view all the answers

    The method most suitable for MTP in the 3rd month of pregnancy is:

    <p>Suction and evacuation</p> Signup and view all the answers

    The best method of evacuation of a missed abortion in a uterus of more than 12 weeks:

    <p>Prostaglandin E1 vaginal misoprostol followed by evacuation of the uterus</p> Signup and view all the answers

    Pregnancy which continues following threatened abortion is likely to have increased incidence of:

    <p>All of the above</p> Signup and view all the answers

    Suction evacuation can be done up to:

    <p>15 weeks</p> Signup and view all the answers

    What is the next best step for a P2+1 female with a positive UPT and signs of nonviable pregnancy?

    <p>High probability of nonviable pregnancy but still repeat scan after 7 days to confirm</p> Signup and view all the answers

    The figure shows a Karman cannula. The number of cannula corresponds to:

    <p>Diameter of cannula in mm</p> Signup and view all the answers

    Identify the instrument:

    <p>Thyroid curved scissors forceps</p> Signup and view all the answers

    Levels of progesterone indicating unviable pregnancy and viable intrauterine pregnancy are:

    <p>5 ng/mL; 20 ng/mL</p> Signup and view all the answers

    Best method for MTP in 2nd trimester abortion:

    <p>Prostaglandin</p> Signup and view all the answers

    In case of recurrent abortions, M/C uterine malformation seen is:

    <p>Mullerian fusion defects</p> Signup and view all the answers

    Study Notes

    Blighted Ovum

    • Defined as an anembryonic gestation characterized by the presence of an empty gestational sac.

    Septic Abortion Complications

    • Most life-threatening complication: Septicemia, followed by peritonitis, renal failure, and respiratory distress syndrome.

    Methods for Medical Termination of Pregnancy (MTP)

    • Third trimester: Suction and evacuation is the preferred method.
    • Second trimester: Prostaglandin is the best method for MTP.

    Missed Abortion Management

    • Best method for evacuation in pregnancies over 12 weeks: Prostaglandin E1 (misoprostol) followed by uterine evacuation.

    Threatened Abortion Outcomes

    • Increased incidence of preterm labor, fetal malformation, and intrauterine growth restriction (IUGR) is noted in pregnancies that continue after a threatened abortion.

    Suction Evacuation Timing

    • Suction evacuation can be performed up to 15 weeks of gestation.

    Diagnostic Approach in Early Pregnancy

    • In cases of non-visible fetal pole and absent cardiac activity on ultrasound, consider advising a repeat scan after 7 days to confirm viability.

    Karman Cannula Usage

    • The number of cannulas indicates the diameter of the cannula in mm, essential for gauging appropriate suction.

    Instrument Identification

    • Recognize common instruments used in obstetrics, such as sponge holding forceps and Allis tissue forceps.

    Progesterone Levels in Pregnancy

    • Levels indicating unviable pregnancy: 5 ng/mL; levels indicating viable intrauterine pregnancy: 50 ng/mL.

    Uterine Malformations and Recurrent Abortions

    • Most common uterine malformation associated with recurrent abortions is a Mullerian fusion defect.

    Common Causes of First Trimester Abortion

    • Chromosomal abnormalities are the leading cause, with trisomy and aneuploidy being frequent culprits.

    Investigation in Recurrent Abortions

    • Karyotyping is sought in cases of recurrent abortions, particularly alongside checking for antiphospholipid antibodies.

    Recognizing Cervical Incompetence

    • Characterized by second-trimester abortions, often managed with a McDonald suture (cervical cerclage).

    Medical Abortion Protocols

    • RU-486 (mifepristone) is effective for inducing abortion up to 63 days into the pregnancy.

    Legalities in MTP

    • Two doctor’s opinions are necessary for abortions beyond 12 weeks under the Medical Termination of Pregnancy Act.

    Contraindications for Medical Abortion

    • Absolute contraindications include suspected ectopic pregnancy and undiagnosed adnexal mass.

    Clinical Presentations

    • Open cervical os with products not expelled indicates inevitable abortion, while a closed os with retained products suggests a missed abortion.

    Thrombophilia and Recurrent Abortions

    • Lupus anticoagulant is commonly associated with recurrent spontaneous abortions.

    Key Medications

    • Mifepristone is not indicated in cases of threatened abortion or ectopic pregnancy.

    Additional Considerations

    • Evaluations should include tests for TORCH infections and autoimmune disorders in women with recurrent abortions, but routine fetal karyotyping may not always be necessary.

    Blighted Ovum

    • Characterized by avascular villi, indicating a form of early miscarriage where no embryo develops.

    Complications of Septic Abortion

    • Respiratory distress syndrome is one of the most life-threatening complications, along with peritonitis and septicemia.

    Methods for Medical Termination of Pregnancy (MTP)

    • Suction and evacuation are preferred for MTP during the third month of pregnancy, allowing for effective and safer procedures.
    • Prostaglandin E1 vaginal misoprostol followed by evacuation is the best option for missed abortions after 12 weeks.

    Incidence after Threatened Abortion

    • Pregnancies that continue after a threatened abortion have increased risks for preterm labor, fetal malformation, and intrauterine growth restriction (IUGR).

    Suction Evacuation Timing

    • Suction evacuation can be performed up to 15 weeks of gestation.

    Next Steps for Nonviable Pregnancy

    • In cases of amenorrhea with a positive UPT but no fetal pole or cardiac activity observed, the best step is to repeat the scan after one week to confirm viability.

    Karman Cannula

    • The diameter of the Karman cannula is indicated in millimeters, relevant for procedures involving manual vacuum aspiration.

    Surgical Instruments

    • Thyroid curved scissors forceps are distinguished as a specific surgical instrument used in various medical procedures.

    Progesterone Levels

    • Levels of progesterone at 5 ng/mL suggest a nonviable pregnancy, while 20 ng/mL is indicative of a viable intrauterine pregnancy.

    MTP in Second Trimester

    • Prostaglandin is the most effective method for medical termination of pregnancy in the second trimester.

    Uterine Malformations in Recurrent Abortions

    • Mullerian fusion defects are the most common uterine malformations associated with recurrent abortions, leading to issues in maintaining pregnancy.

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    Related Documents

    Abortion_and_MTP.pdf
    Abortion_and_MTP (1).docx

    Description

    Test your knowledge on essential topics in obstetrics with this self-assessment quiz featuring new pattern questions. Evaluate your understanding of complications in pregnancy, methods of medical termination, and key terms related to obstetrics. Perfect for students and professionals looking to refresh their expertise in this vital field.

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