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, the 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 32 weeks of gestation presents with sudden severe abdominal pain and vaginal bleeding. Fetal heart rate is non-reassuring. What is the most likely diagnosis?
Placenta previa
Placental abruption
Uterine rupture
Ectopic pregnancy
Explanation - Placental abruption typically presents with sudden onset abdominal pain, vaginal bleeding, and fetal distress after 20 weeks of gestation.
Correct answer is: Placental abruption
Q.3 Which of the following is the first-line treatment for eclampsia?
Labetalol
Magnesium sulfate
Hydralazine
Diazepam
Explanation - Magnesium sulfate is the drug of choice to prevent and control seizures in eclampsia.
Correct answer is: Magnesium sulfate
Q.4 A 35-year-old woman at term develops sudden onset of severe abdominal pain during labor, with loss of fetal station and abnormal fetal heart tracing. What is the most likely diagnosis?
Placenta previa
Uterine rupture
Cord prolapse
Amniotic fluid embolism
Explanation - Uterine rupture presents with sudden severe abdominal pain, fetal distress, and loss of fetal station, often in women with previous cesarean scars.
Correct answer is: Uterine rupture
Q.5 Which of the following signs is most indicative of shoulder dystocia during delivery?
Breech presentation
Turtle sign
Excessive vaginal bleeding
Premature rupture of membranes
Explanation - The 'turtle sign' is when the fetal head retracts back into the perineum after delivery, indicating shoulder dystocia.
Correct answer is: Turtle sign
Q.6 Which of the following is the most critical initial step in managing umbilical cord prolapse?
Immediate cesarean section
Administering oxytocin
Performing manual reduction
Positioning the mother in Trendelenburg
Explanation - Umbilical cord prolapse is an obstetric emergency. The most definitive treatment is an emergency cesarean section, though temporary maternal positioning may relieve cord compression.
Correct answer is: Immediate cesarean section
Q.7 Which of the following is a major risk factor for placental abruption?
Prior cesarean section
Multiple gestation
Maternal hypertension
Polyhydramnios
Explanation - Hypertension, including preeclampsia and chronic hypertension, is a major risk factor for placental abruption.
Correct answer is: Maternal hypertension
Q.8 A 30-year-old woman develops sudden onset shortness of breath, hypotension, and coagulopathy during labor. What is the most likely diagnosis?
Amniotic fluid embolism
Pulmonary embolism
Eclampsia
Anaphylaxis
Explanation - Amniotic fluid embolism is a rare but life-threatening obstetric emergency, presenting with sudden cardiopulmonary collapse and coagulopathy.
Correct answer is: Amniotic fluid embolism
Q.9 Which of the following is the most common cause of postpartum shock in a woman after vaginal delivery?
Septic shock
Postpartum hemorrhage
Amniotic fluid embolism
Pulmonary embolism
Explanation - Postpartum hemorrhage is the leading cause of maternal shock and mortality after delivery.
Correct answer is: Postpartum hemorrhage
Q.10 A 25-year-old woman at 34 weeks presents with painless vaginal bleeding. Fetal heart rate is normal. What is the most likely diagnosis?
Placental abruption
Placenta previa
Vasa previa
Cervical insufficiency
Explanation - Placenta previa usually presents with painless vaginal bleeding after 20 weeks, often without fetal distress.
Correct answer is: Placenta previa
Q.11 Which of the following is a key feature of septic abortion?
Painless vaginal bleeding
Fever, uterine tenderness, and foul-smelling discharge
Hypertonic uterus without bleeding
Severe headache and visual changes
Explanation - Septic abortion is characterized by infection signs including fever, uterine tenderness, and malodorous discharge.
Correct answer is: Fever, uterine tenderness, and foul-smelling discharge
Q.12 Which of the following medications is used to manage uterine atony refractory to oxytocin?
Methylergometrine
Magnesium sulfate
Nifedipine
Betamethasone
Explanation - Methylergometrine is an ergot alkaloid that stimulates uterine contraction, used when oxytocin alone is insufficient.
Correct answer is: Methylergometrine
Q.13 Which fetal complication is most associated with prolonged labor and obstructed labor?
Neonatal sepsis
Meconium aspiration syndrome
Respiratory distress syndrome
Congenital anomalies
Explanation - Prolonged or obstructed labor increases fetal stress, which may cause passage of meconium and aspiration leading to respiratory complications.
Correct answer is: Meconium aspiration syndrome
Q.14 A 32-year-old woman presents with sudden, severe right upper quadrant pain, hypotension, and fetal bradycardia at 36 weeks gestation. Which is the most likely cause?
Placental abruption
Uterine rupture
Cholelithiasis
Appendicitis
Explanation - Uterine rupture often presents with sudden abdominal pain, hypotension, and fetal compromise, especially in late third trimester or labor.
Correct answer is: Uterine rupture
Q.15 Which maneuver is used to relieve shoulder dystocia during delivery?
McRoberts maneuver
Episiotomy
Fundal pressure
External cephalic version
Explanation - The McRoberts maneuver involves hyperflexing the mother's legs to widen the pelvis and facilitate delivery of the impacted shoulder.
Correct answer is: McRoberts maneuver
Q.16 Which of the following is the first step in managing a woman with severe antepartum hemorrhage?
Immediate surgical intervention
Stabilize maternal hemodynamics
Administer antibiotics
Start labor induction
Explanation - In any obstetric hemorrhage, the first priority is maternal stabilization with fluids, blood products, and monitoring before definitive treatment.
Correct answer is: Stabilize maternal hemodynamics
Q.17 Which of the following is the hallmark feature of eclampsia differentiating it from preeclampsia?
Hypertension
Proteinuria
Seizures
Edema
Explanation - Eclampsia is diagnosed when a woman with preeclampsia develops new-onset seizures, which is the key differentiating feature.
Correct answer is: Seizures
Q.18 Which is the most common site for uterine rupture?
Fundus
Anterior lower segment
Posterior wall
Cervix
Explanation - Uterine rupture commonly occurs at the site of previous cesarean section, typically the anterior lower uterine segment.
Correct answer is: Anterior lower segment
Q.19 Which of the following is the most common cause of maternal death in the first 24 hours postpartum?
Sepsis
Hemorrhage
Preeclampsia
Amniotic fluid embolism
Explanation - Postpartum hemorrhage is the leading cause of maternal mortality worldwide, especially within the first 24 hours after delivery.
Correct answer is: Hemorrhage
Q.20 Which of the following is a sign of vasa previa on prenatal ultrasound?
Placental lakes
Fetal vessels crossing the internal cervical os
Thickened placenta
Oligohydramnios
Explanation - Vasa previa is diagnosed when fetal vessels cross the cervical os, posing a high risk of fetal hemorrhage during labor.
Correct answer is: Fetal vessels crossing the internal cervical os
Q.21 Which of the following conditions is most commonly associated with abruptio placentae?
Maternal smoking
Gestational diabetes
Prolonged labor
Breech presentation
Explanation - Maternal smoking is a significant risk factor for placental abruption, along with hypertension and trauma.
Correct answer is: Maternal smoking
Q.22 Which of the following is a life-threatening complication of molar pregnancy?
Hyperthyroidism
Uterine rupture
Trophoblastic embolism
Hemorrhage
Explanation - Molar pregnancy can cause severe hemorrhage due to abnormal trophoblastic proliferation and vascular invasion.
Correct answer is: Hemorrhage
Q.23 Which of the following is the preferred position for a pregnant woman with umbilical cord prolapse before cesarean delivery?
Supine with legs elevated
Trendelenburg or knee-chest position
Left lateral decubitus
Sitting upright
Explanation - Positioning the mother in Trendelenburg or knee-chest position reduces cord compression temporarily until cesarean delivery can be performed.
Correct answer is: Trendelenburg or knee-chest position
Q.24 Which of the following maternal conditions most increases the risk of postpartum hemorrhage?
Grand multiparity
Primigravida
Twin pregnancy
Gestational diabetes
Explanation - Grand multiparity is associated with uterine atony, which is the most common cause of postpartum hemorrhage.
Correct answer is: Grand multiparity