ABOG Obstetric Complications & Emergency Management 3

Question 1

A patient at 37 weeks has BP readings of 145/94 and 148/96 on two occasions 4 hours apart with no proteinuria and no severe features. What is the correct classification?

Accepted Answer

Gestational hypertension

Answer

Preeclampsia without severe features

Answer

Chronic hypertension

Answer

White coat hypertension

Question 2

A pregnant patient at 28 weeks has a BP of 162/108 requiring treatment. Which antihypertensive is contraindicated in pregnancy?

Accepted Answer

Lisinopril

Answer

Labetalol

Answer

Nifedipine

Answer

Hydralazine

Question 3

A biophysical profile (BPP) is performed at 34 weeks with the following findings: fetal breathing present, tone present, gross body movement present, amniotic fluid index 4 cm, but non-stress test non-reactive. What is the BPP score and recommended action?

Accepted Answer

Score 8/10; repeat in 24 hours or deliver if ≥37 weeks

Answer

Score 6/10; deliver immediately

Answer

Score 4/10; deliver within 24 hours

Answer

Score 10/10; routine follow-up

Question 4

A Category III fetal heart rate tracing shows sinusoidal pattern at 39 weeks. What is the most appropriate immediate management?

Accepted Answer

Expedite delivery by the most rapid means available

Answer

Amnioinfusion and oxygen supplementation

Answer

IV fluid bolus and left lateral decubitus position

Answer

Continuous fetal scalp stimulation and observation

Question 5

During active labor at 41 weeks, repetitive variable decelerations to 80 bpm lasting 60 seconds are noted. Cervix is 5 cm dilated. What is the FIRST intrauterine resuscitation step?

Accepted Answer

Maternal position change and discontinue oxytocin

Answer

Emergent cesarean delivery

Answer

Amnioinfusion

Answer

Fetal scalp pH sampling

Question 6

A GBS-positive patient at 39 weeks presents in active labor with a penicillin allergy reported as anaphylaxis. Which antibiotic is most appropriate for GBS intrapartum prophylaxis?

Accepted Answer

Clindamycin (if GBS susceptible)

Answer

Vancomycin

Answer

Ampicillin

Answer

Erythromycin

Question 7

A patient at 31 weeks has spontaneous rupture of membranes confirmed by pooling, ferning, and positive nitrazine. She is afebrile with WBC 9,200 and no contractions. What is the recommended management?

Accepted Answer

Expectant management with antibiotics (latency regimen) and corticosteroids

Answer

Immediate induction of labor

Answer

Tocolysis with nifedipine until 34 weeks

Answer

Amniopatch procedure to reseal membranes