,CHAPTER LIST
Chapter 1: Obstetric History and Examination
Chapter 2: Antenatal Care
Chapter 3: Normal Fetal Development and Growth
Chapter 4: Assessment of Fetal Wellbeing
Chapter 5: Prenatal Diagnosis
Chapter 6: Antenatal Obstetric Complications
Chapter 7: Multiple Pregnancy
Chapter 8: Pre-term Labour
Chapter 9: Hypertensive Disorders of Pregnancy
Chapter 10: Medical Complications of Pregnancy
Chapter 11: Perinatal Infections
Chapter 12: Labour: Normal and Abnormal
Chapter 13: Operative Delivery
Chapter 14: Obstetric Emergencies
Chapter 15: The Puerperium
Chapter 16: The Neonate
,[Chapter 1 – Obstetric History and Examination]
Question 1 | Type: MCQ-Recall | Cognitive Level: Recall
Which of the following best defines gravidity in obstetric notation?
A. The number of pregnancies reaching viability
B. The number of live births
C. The total number of pregnancies regardless of outcome
D. The number of pregnancies beyond 24 weeks’ gestation
E. The number of miscarriages and terminations
✅ Correct Answer: C. The total number of pregnancies regardless of
outcome
📖 Rationale:
Gravidity refers to the total number of times a woman has been pregnant,
irrespective of the outcome, including current pregnancy, miscarriages,
terminations, and ectopic pregnancies. This definition is fundamental in
obstetric history-taking and is used alongside parity to describe reproductive
history accurately. It provides a comprehensive overview of a woman's
reproductive exposure, which is essential in risk stratification. Accurate
recording of gravidity ensures appropriate clinical interpretation during
antenatal care.
Question 2 | Type: MCQ-Recall | Cognitive Level: Recall
Parity is defined as:
A. The number of pregnancies including the current one
B. The number of pregnancies reaching a viable gestation
C. The number of live births only
D. The number of pregnancies ending before 20 weeks
E. The number of caesarean deliveries
✅ Correct Answer: B. The number of pregnancies reaching a viable
gestation
📖 Rationale:
Parity refers to the number of pregnancies that have reached viability, typically
defined as 24 weeks’ gestation or beyond, regardless of whether the fetus was
,born alive or stillborn. This measure reflects the woman’s obstetric experience
with advanced pregnancies, which has implications for future pregnancy risks.
It differs from gravidity by excluding early pregnancy losses. Accurate
documentation of parity helps clinicians anticipate complications such as
preterm birth or uterine scarring.
Question 3 | Type: MCQ-Recall | Cognitive Level: Recall
Which component is NOT typically included in a structured obstetric history?
A. Presenting complaint
B. Obstetric history
C. Occupational history
D. Gynaecological history
E. Drug history
✅ Correct Answer: C. Occupational history
📖 Rationale:
A structured obstetric history includes presenting complaint, obstetric history,
gynaecological history, and medical, surgical, drug, and social histories.
Occupational history may be explored under the broader social history but is
not a core standalone component in the structured obstetric framework. The
emphasis is on factors directly influencing pregnancy and maternal-fetal
outcomes. Maintaining this structure ensures completeness and consistency in
clinical assessment.
Question 4 | Type: MCQ-Recall | Cognitive Level: Recall
Which of the following is the primary purpose of the booking visit?
A. To confirm fetal viability
B. To establish baseline maternal health and identify risk factors
C. To initiate labour planning
D. To perform routine vaginal examination
E. To determine fetal presentation
✅ Correct Answer: B. To establish baseline maternal health and identify
risk factors
,📖 Rationale:
The booking visit is a critical early antenatal appointment aimed at establishing
baseline maternal health and identifying risk factors that may affect pregnancy
outcomes. It involves comprehensive history-taking, examination, and initial
investigations. Early identification of high-risk conditions allows for tailored
antenatal care pathways. This visit forms the foundation for ongoing
monitoring and management throughout pregnancy.
Question 5 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
Why is symphysis-fundal height (SFH) measurement important in antenatal
care?
A. It confirms fetal heart activity
B. It determines fetal gender
C. It assesses fetal growth over time
D. It diagnoses fetal anomalies
E. It measures amniotic fluid composition
✅ Correct Answer: C. It assesses fetal growth over time
📖 Rationale:
SFH measurement provides a simple, non-invasive method of monitoring fetal
growth longitudinally. By comparing measurements with gestational age,
clinicians can detect deviations such as growth restriction or macrosomia.
Serial measurements are more informative than single readings, allowing
identification of trends. This makes SFH a valuable screening tool in routine
antenatal care.
Question 6 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
What is the clinical significance of determining fetal lie during abdominal
examination?
A. It identifies placental position
B. It predicts fetal weight
C. It determines orientation of the fetus in relation to the uterus
D. It assesses cervical readiness
E. It confirms gestational age
,✅ Correct Answer: C. It determines orientation of the fetus in relation to
the uterus
📖 Rationale:
Fetal lie describes the relationship between the longitudinal axis of the fetus
and that of the uterus. It is crucial for anticipating the mode of delivery, as
abnormal lies (e.g., transverse) are incompatible with vaginal delivery.
Identifying the lie helps guide further assessment of presentation and
engagement. Understanding fetal orientation is essential for safe obstetric
management.
Question 7 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
The Bishop score is primarily used to:
A. Assess fetal wellbeing
B. Predict likelihood of successful induction of labour
C. Determine gestational age
D. Diagnose placental abnormalities
E. Measure uterine contractions
✅ Correct Answer: B. Predict likelihood of successful induction of labour
📖 Rationale:
The Bishop score evaluates cervical readiness for labour by assessing dilation,
effacement, consistency, position, and fetal station. It is used to predict the
likelihood of successful induction of labour. A higher score indicates a
favourable cervix and increased chance of vaginal delivery. This scoring system
helps guide clinical decisions regarding induction methods.
Question 8 | Type: MCQ-Application | Cognitive Level:
Application
A 28-year-old G3P1+1 woman presents at 30 weeks’ gestation. What does this
notation indicate?
A. Three pregnancies, one live birth, one miscarriage
B. Three live births and one miscarriage
C. Three pregnancies, one preterm delivery, one stillbirth
,D. Two pregnancies and one ectopic pregnancy
E. Three pregnancies and one termination
✅ Correct Answer: A. Three pregnancies, one live birth, one miscarriage
📖 Rationale:
G3 indicates three total pregnancies, including the current one. P1 indicates
one pregnancy reaching viability, and +1 represents one pregnancy loss
(miscarriage or termination before viability). This notation allows quick
interpretation of reproductive history. Understanding this format is essential
for assessing obstetric risk and planning care.
Question 9 | Type: MCQ-Application | Cognitive Level:
Application
A pregnant woman’s SFH measures 28 cm at 32 weeks’ gestation. What is the
most appropriate interpretation?
A. Normal finding
B. Suggestive of fetal macrosomia
C. Suggestive of fetal growth restriction
D. Indicates multiple pregnancy
E. Confirms incorrect dating
✅ Correct Answer: C. Suggestive of fetal growth restriction
📖 Rationale:
SFH in centimetres generally corresponds to gestational age within ±2 cm after
24 weeks. A measurement significantly below expected (by more than 2–3 cm)
suggests possible fetal growth restriction. This finding warrants further
assessment, typically with ultrasound. Early detection is critical to prevent
adverse outcomes.
Question 10 | Type: MCQ-Application | Cognitive Level:
Application
During abdominal palpation, the fetal head is not palpable in the fundus but is
felt in the pelvis. What is the likely presentation?
A. Breech
B. Cephalic
, C. Transverse
D. Oblique
E. Compound
✅ Correct Answer: B. Cephalic
📖 Rationale:
In cephalic presentation, the fetal head is positioned in the pelvis, while the
buttocks occupy the fundus. This is the most common and favourable
presentation for vaginal delivery. Palpation findings help determine
presentation during antenatal assessment. Identifying this correctly guides
delivery planning.
Question 11 | Type: MCQ-Application | Cognitive Level:
Application
A vaginal examination reveals a cervix that is 3 cm dilated, 50% effaced, soft,
and anterior. What does this suggest?
A. Low Bishop score
B. Unfavourable cervix
C. High likelihood of successful induction
D. Cervical incompetence
E. Preterm labour
✅ Correct Answer: C. High likelihood of successful induction
📖 Rationale:
These cervical features correspond to a favourable Bishop score, indicating
readiness for labour. A soft, anterior cervix with dilation and effacement
increases the probability of successful induction. The Bishop score integrates
these parameters to guide management decisions. This assessment is essential
before initiating induction.
Question 12 | Type: MCQ-Analysis | Cognitive Level: Analysis
A 35-year-old G5P3 woman presents for booking. She has a history of two
miscarriages and three term deliveries. Which is the correct notation?
A. G5P3+2
B. G5P5
Chapter 1: Obstetric History and Examination
Chapter 2: Antenatal Care
Chapter 3: Normal Fetal Development and Growth
Chapter 4: Assessment of Fetal Wellbeing
Chapter 5: Prenatal Diagnosis
Chapter 6: Antenatal Obstetric Complications
Chapter 7: Multiple Pregnancy
Chapter 8: Pre-term Labour
Chapter 9: Hypertensive Disorders of Pregnancy
Chapter 10: Medical Complications of Pregnancy
Chapter 11: Perinatal Infections
Chapter 12: Labour: Normal and Abnormal
Chapter 13: Operative Delivery
Chapter 14: Obstetric Emergencies
Chapter 15: The Puerperium
Chapter 16: The Neonate
,[Chapter 1 – Obstetric History and Examination]
Question 1 | Type: MCQ-Recall | Cognitive Level: Recall
Which of the following best defines gravidity in obstetric notation?
A. The number of pregnancies reaching viability
B. The number of live births
C. The total number of pregnancies regardless of outcome
D. The number of pregnancies beyond 24 weeks’ gestation
E. The number of miscarriages and terminations
✅ Correct Answer: C. The total number of pregnancies regardless of
outcome
📖 Rationale:
Gravidity refers to the total number of times a woman has been pregnant,
irrespective of the outcome, including current pregnancy, miscarriages,
terminations, and ectopic pregnancies. This definition is fundamental in
obstetric history-taking and is used alongside parity to describe reproductive
history accurately. It provides a comprehensive overview of a woman's
reproductive exposure, which is essential in risk stratification. Accurate
recording of gravidity ensures appropriate clinical interpretation during
antenatal care.
Question 2 | Type: MCQ-Recall | Cognitive Level: Recall
Parity is defined as:
A. The number of pregnancies including the current one
B. The number of pregnancies reaching a viable gestation
C. The number of live births only
D. The number of pregnancies ending before 20 weeks
E. The number of caesarean deliveries
✅ Correct Answer: B. The number of pregnancies reaching a viable
gestation
📖 Rationale:
Parity refers to the number of pregnancies that have reached viability, typically
defined as 24 weeks’ gestation or beyond, regardless of whether the fetus was
,born alive or stillborn. This measure reflects the woman’s obstetric experience
with advanced pregnancies, which has implications for future pregnancy risks.
It differs from gravidity by excluding early pregnancy losses. Accurate
documentation of parity helps clinicians anticipate complications such as
preterm birth or uterine scarring.
Question 3 | Type: MCQ-Recall | Cognitive Level: Recall
Which component is NOT typically included in a structured obstetric history?
A. Presenting complaint
B. Obstetric history
C. Occupational history
D. Gynaecological history
E. Drug history
✅ Correct Answer: C. Occupational history
📖 Rationale:
A structured obstetric history includes presenting complaint, obstetric history,
gynaecological history, and medical, surgical, drug, and social histories.
Occupational history may be explored under the broader social history but is
not a core standalone component in the structured obstetric framework. The
emphasis is on factors directly influencing pregnancy and maternal-fetal
outcomes. Maintaining this structure ensures completeness and consistency in
clinical assessment.
Question 4 | Type: MCQ-Recall | Cognitive Level: Recall
Which of the following is the primary purpose of the booking visit?
A. To confirm fetal viability
B. To establish baseline maternal health and identify risk factors
C. To initiate labour planning
D. To perform routine vaginal examination
E. To determine fetal presentation
✅ Correct Answer: B. To establish baseline maternal health and identify
risk factors
,📖 Rationale:
The booking visit is a critical early antenatal appointment aimed at establishing
baseline maternal health and identifying risk factors that may affect pregnancy
outcomes. It involves comprehensive history-taking, examination, and initial
investigations. Early identification of high-risk conditions allows for tailored
antenatal care pathways. This visit forms the foundation for ongoing
monitoring and management throughout pregnancy.
Question 5 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
Why is symphysis-fundal height (SFH) measurement important in antenatal
care?
A. It confirms fetal heart activity
B. It determines fetal gender
C. It assesses fetal growth over time
D. It diagnoses fetal anomalies
E. It measures amniotic fluid composition
✅ Correct Answer: C. It assesses fetal growth over time
📖 Rationale:
SFH measurement provides a simple, non-invasive method of monitoring fetal
growth longitudinally. By comparing measurements with gestational age,
clinicians can detect deviations such as growth restriction or macrosomia.
Serial measurements are more informative than single readings, allowing
identification of trends. This makes SFH a valuable screening tool in routine
antenatal care.
Question 6 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
What is the clinical significance of determining fetal lie during abdominal
examination?
A. It identifies placental position
B. It predicts fetal weight
C. It determines orientation of the fetus in relation to the uterus
D. It assesses cervical readiness
E. It confirms gestational age
,✅ Correct Answer: C. It determines orientation of the fetus in relation to
the uterus
📖 Rationale:
Fetal lie describes the relationship between the longitudinal axis of the fetus
and that of the uterus. It is crucial for anticipating the mode of delivery, as
abnormal lies (e.g., transverse) are incompatible with vaginal delivery.
Identifying the lie helps guide further assessment of presentation and
engagement. Understanding fetal orientation is essential for safe obstetric
management.
Question 7 | Type: MCQ-Comprehension | Cognitive Level:
Comprehension
The Bishop score is primarily used to:
A. Assess fetal wellbeing
B. Predict likelihood of successful induction of labour
C. Determine gestational age
D. Diagnose placental abnormalities
E. Measure uterine contractions
✅ Correct Answer: B. Predict likelihood of successful induction of labour
📖 Rationale:
The Bishop score evaluates cervical readiness for labour by assessing dilation,
effacement, consistency, position, and fetal station. It is used to predict the
likelihood of successful induction of labour. A higher score indicates a
favourable cervix and increased chance of vaginal delivery. This scoring system
helps guide clinical decisions regarding induction methods.
Question 8 | Type: MCQ-Application | Cognitive Level:
Application
A 28-year-old G3P1+1 woman presents at 30 weeks’ gestation. What does this
notation indicate?
A. Three pregnancies, one live birth, one miscarriage
B. Three live births and one miscarriage
C. Three pregnancies, one preterm delivery, one stillbirth
,D. Two pregnancies and one ectopic pregnancy
E. Three pregnancies and one termination
✅ Correct Answer: A. Three pregnancies, one live birth, one miscarriage
📖 Rationale:
G3 indicates three total pregnancies, including the current one. P1 indicates
one pregnancy reaching viability, and +1 represents one pregnancy loss
(miscarriage or termination before viability). This notation allows quick
interpretation of reproductive history. Understanding this format is essential
for assessing obstetric risk and planning care.
Question 9 | Type: MCQ-Application | Cognitive Level:
Application
A pregnant woman’s SFH measures 28 cm at 32 weeks’ gestation. What is the
most appropriate interpretation?
A. Normal finding
B. Suggestive of fetal macrosomia
C. Suggestive of fetal growth restriction
D. Indicates multiple pregnancy
E. Confirms incorrect dating
✅ Correct Answer: C. Suggestive of fetal growth restriction
📖 Rationale:
SFH in centimetres generally corresponds to gestational age within ±2 cm after
24 weeks. A measurement significantly below expected (by more than 2–3 cm)
suggests possible fetal growth restriction. This finding warrants further
assessment, typically with ultrasound. Early detection is critical to prevent
adverse outcomes.
Question 10 | Type: MCQ-Application | Cognitive Level:
Application
During abdominal palpation, the fetal head is not palpable in the fundus but is
felt in the pelvis. What is the likely presentation?
A. Breech
B. Cephalic
, C. Transverse
D. Oblique
E. Compound
✅ Correct Answer: B. Cephalic
📖 Rationale:
In cephalic presentation, the fetal head is positioned in the pelvis, while the
buttocks occupy the fundus. This is the most common and favourable
presentation for vaginal delivery. Palpation findings help determine
presentation during antenatal assessment. Identifying this correctly guides
delivery planning.
Question 11 | Type: MCQ-Application | Cognitive Level:
Application
A vaginal examination reveals a cervix that is 3 cm dilated, 50% effaced, soft,
and anterior. What does this suggest?
A. Low Bishop score
B. Unfavourable cervix
C. High likelihood of successful induction
D. Cervical incompetence
E. Preterm labour
✅ Correct Answer: C. High likelihood of successful induction
📖 Rationale:
These cervical features correspond to a favourable Bishop score, indicating
readiness for labour. A soft, anterior cervix with dilation and effacement
increases the probability of successful induction. The Bishop score integrates
these parameters to guide management decisions. This assessment is essential
before initiating induction.
Question 12 | Type: MCQ-Analysis | Cognitive Level: Analysis
A 35-year-old G5P3 woman presents for booking. She has a history of two
miscarriages and three term deliveries. Which is the correct notation?
A. G5P3+2
B. G5P5
