OB/GYN - ACOG/UWORLD Verified Exam Questions and Answers
Latest update 2026/2027
Question:
G1P0 woman at 36 weeks presents w/ persistent wetness of her underwear and now has fever and
uterine tenderness. Lab values show Leukocytosis.
Answer:
CHORIOAMNIONITIS Premature prolonged rupture of membranes = PROM - Premature = rupture
<37 weeks; Prolonged = rupture lasting >18 hours w/o delivery; Usually PPROM refers to preterm
premature rupture of the membranes
- All descriptions of fluid point to amniotic fluid.
Question:
Fluid pooled in posterior vaginal fornix is nitrazine positive and has ferning pattern on cover slip
Answer:
Increased risk of Chorioamnionitis and Abruptio placenta. DX here = Chorioamnionitis
Question:
Other possible sx = maternal or fetal tachycardia, purulent vaginal discharge, malodorous amniotic
fluid.
Answer:
TX here =
1. Broad spectrum antibiotics covering anaerobes and genital/enteric flora =
Ampicillin/.Gentamicin and Clindamycin
Question:
DX and TX?
Answer:
2. Administer Oxytocin to induce labor. Since there are signs of infection, DELIVER
regardless of gestational age (give corticosteriods for fetal lungs + antibiotics) Remember tocolysis
contraindicated in the setting of Chorioamniotitis. For PPROM, start Ampicilllin and Erythromycin
(not as chorio prophylaxis), but as a pseudotocolytic which prolongs pregnancy by 5-7 days and
allows time to get
Question:
Other things that increase the risk of chorioamnionitis?
Answer:
betamethasone injections Prolonged rupture of membranes Frequent cervical checks Intrauterine
monitoring devices (IUPC, etc) Prolonged labor
,Question:
Patient who are likely to deliver preterm infant <34 weeks should get what?
Answer:
Presence of genital tract pathogens Corticosteroids IM (betamethasone) - 2 doses 24 hours apart to
help fetal lung maturity
Question:
What two things are done in pretty much all patients w/ PROM?
Answer:
34-37 weeks
1. Antibiotics (Amp+Erythro for prolongation of pregnancy by 5-7 days)
2. +Corticosteroids (technically <34 weeks, but usually this is done up until 37 weeks
for vaginal due to potential dating issues; also given <39 weeks for scheduled CS)
3. delivery - deliver even prior to 34 weeks if signs of chorioamnionitis are present. If
Chorio develops, delivery is indicated regardless of gestational age.
Question:
Patient w/ PROM at <34 weeks
Answer:
<34 weeks - goal is prolongation of pregnancy if no signs of infection
- antibiotics (Ampicillin + Erythromycin)
- IM Betamethasone
- Mag is usually started <32 weeks for neuroprotection regardless of presence of
preeclampsia (in delivery likely in next 24 hours)
- indocin also started prior to 32 weeks (AE = oligo, PDA closure, IVH, necrotizing
entercolitis)
- Fetal monitoring
Question:
If patient has PROM at 35 weeks and GBS is unknown - do what?
Answer:
- if signs of fetal infection or compromise ( --> Abx, corticosteroids, magnesium if
<34 weeks, DELIVERY) Intrapartum IV penicillin should be given - assume she has it. Normal
vaginal flora in ~25% of women. This really applies to any precipitous labor in which the GBS status
is unknown. Also do it if they have had GBS bactiuria/UTI at any point in the pregnancy AND/OR
have had a previous delivery complicated by neonatal GBS
, Question:
Late pregnant + Description of previous stress incontinence (laugh, cough = pee) + now presenting w/
increased nitrazine positive fluid in vagina + low amniotic fluid indices = ?
Answer:
septicemia/pneumonia/meningitis. Goal is to get intrapartum IV penicillin on board for 4 hours before
baby's arrival. Just assuming SROM/PROM here and ignore the pee symptoms since it has a LOW
AFI Even though urine in pregnancy can be basic and cause nitrazine blue paper reaction, if they say
that amniotic fluid indices are low, this points to patient now
Question:
Recurrent variable decelerations = tx?
Answer:
having PROM. Signs of umbilical cord compression. If mild/moderate may not require interventions.
If severe think amnioinfusion or generic interventions such as left lateral rest, etc. In the setting of
recurrent variable following AROM and confirmation of cord
Question:
Patient presents at >34 weeks w/ PROM - do what?
Answer:
prolapse, would lift fetal head and proceed to CS. Antibiotics (Amp+erythro for prolongation)
Corticosteroids Delivery
Question:
Late-term = ?
Answer:
41-42 weeks = late term >42 weeks = postterm pregnancy Complications Oligohydramnios
Macrosomia - think about all of the complications that happen w/ this as a result of fetal hypoxia
(polycythemia, hyperbilirubinemia, etc) - increased risk of shoulder dystocia
Question:
Complications?
Answer:
Uterine atony (due to over distention) Perineal trauma (due to macrosomia) IUFD Placental
Dysmaturity syndrome --> Baby had grey/green look, long nails, contractures. Infection Fetal
Convulsions
Latest update 2026/2027
Question:
G1P0 woman at 36 weeks presents w/ persistent wetness of her underwear and now has fever and
uterine tenderness. Lab values show Leukocytosis.
Answer:
CHORIOAMNIONITIS Premature prolonged rupture of membranes = PROM - Premature = rupture
<37 weeks; Prolonged = rupture lasting >18 hours w/o delivery; Usually PPROM refers to preterm
premature rupture of the membranes
- All descriptions of fluid point to amniotic fluid.
Question:
Fluid pooled in posterior vaginal fornix is nitrazine positive and has ferning pattern on cover slip
Answer:
Increased risk of Chorioamnionitis and Abruptio placenta. DX here = Chorioamnionitis
Question:
Other possible sx = maternal or fetal tachycardia, purulent vaginal discharge, malodorous amniotic
fluid.
Answer:
TX here =
1. Broad spectrum antibiotics covering anaerobes and genital/enteric flora =
Ampicillin/.Gentamicin and Clindamycin
Question:
DX and TX?
Answer:
2. Administer Oxytocin to induce labor. Since there are signs of infection, DELIVER
regardless of gestational age (give corticosteriods for fetal lungs + antibiotics) Remember tocolysis
contraindicated in the setting of Chorioamniotitis. For PPROM, start Ampicilllin and Erythromycin
(not as chorio prophylaxis), but as a pseudotocolytic which prolongs pregnancy by 5-7 days and
allows time to get
Question:
Other things that increase the risk of chorioamnionitis?
Answer:
betamethasone injections Prolonged rupture of membranes Frequent cervical checks Intrauterine
monitoring devices (IUPC, etc) Prolonged labor
,Question:
Patient who are likely to deliver preterm infant <34 weeks should get what?
Answer:
Presence of genital tract pathogens Corticosteroids IM (betamethasone) - 2 doses 24 hours apart to
help fetal lung maturity
Question:
What two things are done in pretty much all patients w/ PROM?
Answer:
34-37 weeks
1. Antibiotics (Amp+Erythro for prolongation of pregnancy by 5-7 days)
2. +Corticosteroids (technically <34 weeks, but usually this is done up until 37 weeks
for vaginal due to potential dating issues; also given <39 weeks for scheduled CS)
3. delivery - deliver even prior to 34 weeks if signs of chorioamnionitis are present. If
Chorio develops, delivery is indicated regardless of gestational age.
Question:
Patient w/ PROM at <34 weeks
Answer:
<34 weeks - goal is prolongation of pregnancy if no signs of infection
- antibiotics (Ampicillin + Erythromycin)
- IM Betamethasone
- Mag is usually started <32 weeks for neuroprotection regardless of presence of
preeclampsia (in delivery likely in next 24 hours)
- indocin also started prior to 32 weeks (AE = oligo, PDA closure, IVH, necrotizing
entercolitis)
- Fetal monitoring
Question:
If patient has PROM at 35 weeks and GBS is unknown - do what?
Answer:
- if signs of fetal infection or compromise ( --> Abx, corticosteroids, magnesium if
<34 weeks, DELIVERY) Intrapartum IV penicillin should be given - assume she has it. Normal
vaginal flora in ~25% of women. This really applies to any precipitous labor in which the GBS status
is unknown. Also do it if they have had GBS bactiuria/UTI at any point in the pregnancy AND/OR
have had a previous delivery complicated by neonatal GBS
, Question:
Late pregnant + Description of previous stress incontinence (laugh, cough = pee) + now presenting w/
increased nitrazine positive fluid in vagina + low amniotic fluid indices = ?
Answer:
septicemia/pneumonia/meningitis. Goal is to get intrapartum IV penicillin on board for 4 hours before
baby's arrival. Just assuming SROM/PROM here and ignore the pee symptoms since it has a LOW
AFI Even though urine in pregnancy can be basic and cause nitrazine blue paper reaction, if they say
that amniotic fluid indices are low, this points to patient now
Question:
Recurrent variable decelerations = tx?
Answer:
having PROM. Signs of umbilical cord compression. If mild/moderate may not require interventions.
If severe think amnioinfusion or generic interventions such as left lateral rest, etc. In the setting of
recurrent variable following AROM and confirmation of cord
Question:
Patient presents at >34 weeks w/ PROM - do what?
Answer:
prolapse, would lift fetal head and proceed to CS. Antibiotics (Amp+erythro for prolongation)
Corticosteroids Delivery
Question:
Late-term = ?
Answer:
41-42 weeks = late term >42 weeks = postterm pregnancy Complications Oligohydramnios
Macrosomia - think about all of the complications that happen w/ this as a result of fetal hypoxia
(polycythemia, hyperbilirubinemia, etc) - increased risk of shoulder dystocia
Question:
Complications?
Answer:
Uterine atony (due to over distention) Perineal trauma (due to macrosomia) IUFD Placental
Dysmaturity syndrome --> Baby had grey/green look, long nails, contractures. Infection Fetal
Convulsions
