Q.1 Which of the following is the most common cause of postpartum hemorrhage?
Retained placenta
Uterine atony
Genital tract trauma
Coagulopathy
Explanation - Uterine atony, or failure of the uterus to contract effectively after delivery, is the most common cause of postpartum hemorrhage.
Correct answer is: Uterine atony
Q.2 A 28-year-old woman at 34 weeks gestation presents with sudden painless vaginal bleeding. What is the most likely diagnosis?
Placenta previa
Placental abruption
Vasa previa
Uterine rupture
Explanation - Placenta previa often presents with painless, bright red vaginal bleeding in the third trimester.
Correct answer is: Placenta previa
Q.3 Which sign is most indicative of eclampsia rather than preeclampsia?
Proteinuria
Severe hypertension
Seizures
Edema
Explanation - Eclampsia is diagnosed when a woman with preeclampsia develops seizures that cannot be attributed to other causes.
Correct answer is: Seizures
Q.4 What is the first-line treatment for severe preeclampsia to prevent eclampsia?
Magnesium sulfate
Labetalol
Hydralazine
Diazepam
Explanation - Magnesium sulfate is used to prevent seizures in women with severe preeclampsia and is the drug of choice for eclampsia prophylaxis.
Correct answer is: Magnesium sulfate
Q.5 A 32-week pregnant woman presents with sudden onset severe abdominal pain and vaginal bleeding. Fetal heart rate is non-reassuring. What is the most likely cause?
Placenta previa
Placental abruption
Preterm labor
Uterine rupture
Explanation - Placental abruption presents with sudden, painful vaginal bleeding, uterine tenderness, and fetal distress.
Correct answer is: Placental abruption
Q.6 Which condition is characterized by painless, bright red bleeding in the third trimester?
Placental abruption
Placenta previa
Cervical laceration
Uterine rupture
Explanation - Placenta previa causes painless bleeding, usually bright red, in the late second or third trimester.
Correct answer is: Placenta previa
Q.7 A woman in labor suddenly experiences hypotension, fetal bradycardia, and abdominal pain. Which obstetric emergency is most likely?
Uterine rupture
Placenta previa
Placental abruption
Amniotic fluid embolism
Explanation - Uterine rupture often presents during labor with maternal hypotension, fetal distress, and abdominal pain.
Correct answer is: Uterine rupture
Q.8 Which is the most important immediate management step in shoulder dystocia?
Episiotomy
McRoberts maneuver
Forceps delivery
Cesarean section
Explanation - The McRoberts maneuver, hyperflexing the maternal hips, is first-line to relieve shoulder dystocia by widening the pelvis.
Correct answer is: McRoberts maneuver
Q.9 Which is the hallmark triad of amniotic fluid embolism?
Seizures, hypertension, proteinuria
Dyspnea, hypotension, coagulopathy
Fever, abdominal pain, vaginal bleeding
Bradycardia, hypertension, oliguria
Explanation - Amniotic fluid embolism presents acutely with sudden respiratory distress, cardiovascular collapse, and disseminated intravascular coagulation.
Correct answer is: Dyspnea, hypotension, coagulopathy
Q.10 Which drug is preferred to treat postpartum hemorrhage due to uterine atony?
Oxytocin
Misoprostol
Carboprost
Ergometrine
Explanation - Oxytocin is first-line for managing uterine atony and preventing postpartum hemorrhage.
Correct answer is: Oxytocin
Q.11 A 36-week pregnant woman presents with sudden severe chest pain and hypotension during labor. She is at risk of which rare but life-threatening obstetric emergency?
Pulmonary embolism
Uterine rupture
Amniotic fluid embolism
Placenta previa
Explanation - Amniotic fluid embolism is a rare but catastrophic event during labor or immediately postpartum, presenting with cardiovascular collapse and respiratory failure.
Correct answer is: Amniotic fluid embolism
Q.12 Which of the following is a risk factor for uterine rupture?
Previous cesarean section
Primigravida at term
Placenta previa
Gestational diabetes
Explanation - A previous uterine scar from cesarean section increases the risk of rupture during labor.
Correct answer is: Previous cesarean section
Q.13 Which is the most common cause of maternal death in the first 24 hours postpartum?
Postpartum hemorrhage
Eclampsia
Amniotic fluid embolism
Sepsis
Explanation - Postpartum hemorrhage is the leading cause of maternal mortality in the immediate postpartum period worldwide.
Correct answer is: Postpartum hemorrhage
Q.14 A woman at 28 weeks gestation presents with hypertension, proteinuria, and headache. What is the most likely diagnosis?
Chronic hypertension
Gestational hypertension
Preeclampsia
Eclampsia
Explanation - Preeclampsia is defined as new-onset hypertension and proteinuria after 20 weeks gestation.
Correct answer is: Preeclampsia
Q.15 Which maneuver is commonly used to relieve umbilical cord prolapse?
Knee-chest position
McRoberts maneuver
Fundal pressure
Vaginal packing
Explanation - Placing the mother in a knee-chest position can relieve pressure on the prolapsed umbilical cord until delivery.
Correct answer is: Knee-chest position
Q.16 Which obstetric emergency is characterized by 'contractions that are more frequent and intense than expected with fetal compromise'?
Hypertonic uterine contractions
Placental abruption
Preterm labor
Uterine rupture
Explanation - Hypertonic uterine contractions can cause fetal distress due to decreased placental perfusion.
Correct answer is: Hypertonic uterine contractions
Q.17 A pregnant woman presents with sudden, severe right upper quadrant pain, nausea, and vomiting. Her blood pressure is elevated. Which complication is likely?
Acute fatty liver of pregnancy
HELLP syndrome
Cholecystitis
Preeclampsia without severe features
Explanation - HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) often presents with right upper quadrant pain, nausea, vomiting, and hypertension.
Correct answer is: HELLP syndrome
Q.18 What is the definitive treatment for placenta previa with persistent bleeding at 36 weeks?
Expectant management
Vaginal delivery
Cesarean section
Uterine artery embolization
Explanation - Placenta previa with significant bleeding near term is an indication for cesarean delivery.
Correct answer is: Cesarean section
Q.19 Which of the following is a classic feature of cord prolapse?
Sudden fetal bradycardia
Painless vaginal bleeding
Severe headache
Hypertension
Explanation - Umbilical cord prolapse causes acute compression of the cord, leading to sudden fetal bradycardia or variable decelerations.
Correct answer is: Sudden fetal bradycardia
Q.20 Which emergency drug is indicated for controlling severe hypertension in preeclampsia?
Hydralazine
Magnesium sulfate
Nifedipine
Labetalol
Explanation - Labetalol is commonly used for rapid control of severe hypertension in preeclampsia.
Correct answer is: Labetalol
Q.21 Which factor increases the risk of postpartum hemorrhage?
Prolonged labor
Multiparity
Polyhydramnios
All of the above
Explanation - Prolonged labor, multiparity, and polyhydramnios are all recognized risk factors for postpartum hemorrhage.
Correct answer is: All of the above
Q.22 Which of the following is the first step in managing eclampsia during labor?
Immediate cesarean section
Administer magnesium sulfate
Start antihypertensives
Provide oxygen only
Explanation - The first step in managing eclampsia is seizure control using magnesium sulfate; delivery timing is determined after stabilization.
Correct answer is: Administer magnesium sulfate
Q.23 Which condition is associated with the classic 'banana-shaped' fetus on ultrasound due to abnormal spinal curvature?
Amniotic band syndrome
Uterine rupture
Sacral agenesis
Oligohydramnios sequence
Explanation - Severe oligohydramnios can lead to fetal deformation, including the 'banana-shaped' appearance due to compression and abnormal curvature.
Correct answer is: Oligohydramnios sequence
Q.24 Which is the most important intervention in a patient with massive postpartum hemorrhage?
Volume resuscitation and uterotonics
Antibiotics
Magnesium sulfate
Positioning only
Explanation - Rapid fluid replacement and uterotonic drugs are crucial to stabilize a patient and control bleeding in postpartum hemorrhage.
Correct answer is: Volume resuscitation and uterotonics