OB FINAL EXAM ACTUAL SCRIPT 2026
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ Probable Signs of Pregnancy.
Answer: Objective signs observed by examiner: Goodell's sign,
Chadwick's sign, Hegar's sign (softening of lower uterus), positive
urine/serum pregnancy test (hCG), Braxton Hicks contractions,
ballottement, abdominal enlargement
◉ Positive Signs of Pregnancy.
Answer: Definitive confirmation of pregnancy: fetal heartbeat heard
by Doppler/fetoscope, fetal movement felt by examiner, fetal
visualization by ultrasound
◉ Goodell's Sign.
Answer: Softening of the cervix due to increased vascularity and
edema; occurs ~4-6 weeks gestation; a PROBABLE sign of
pregnancy
◉ Chadwick's Sign.
,Answer: Bluish-violet discoloration of the cervix, vagina, and vulva
due to increased blood flow/vascularity; appears ~6-8 weeks; a
PROBABLE sign of pregnancy
◉ Nagele's Rule.
Answer: Formula to calculate EDD: Take LMP → subtract 3 months
→ add 7 days → adjust year if needed. Example: LMP Oct 1 → July 1
→ July 8 = EDD
◉ GTPAL Notation.
Answer: G=Gravida (total pregnancies); T=Term births (≥37 wks);
P=Preterm births (20-36 6/7 wks); A=Abortions/miscarriages (<20
wks); L=Living children. Ex: G3T2P0A1L2
◉ Fundal Height.
Answer: Measured in cm from pubic symphysis to top of uterus;
after 20 weeks, cm ≈ weeks of gestation (±2 cm). At umbilicus = ~20
weeks. Used to assess fetal growth.
◉ Leopold's Maneuvers.
Answer: 4 systematic abdominal palpations: 1st-fundal grip (fetal
part in fundus); 2nd-lateral grip (fetal back vs extremities); 3rd-
Pawlik's grip (presenting part); 4th-pelvic grip (degree of
descent/engagement)
,◉ Fetal Movements (Kick Counts).
Answer: Patient counts fetal movements daily; report if <10
movements in 2 hours. Cardiff method: count to 10 in 12 hrs.
Decreased movement = notify provider immediately
◉ Quickening.
Answer: First maternal perception of fetal movement; primigravidas
~18-20 weeks; multigravidas ~16-18 weeks; a PRESUMPTIVE sign
of pregnancy
◉ Fetal Circulation - Key Structures.
Answer: Ductus venosus (bypasses liver), Foramen ovale (bypasses
lungs R→L atria), Ductus arteriosus (bypasses lungs pulmonary
artery→aorta). Oxygenated blood comes from placenta via umbilical
vein.
◉ Umbilical Cord Structure.
Answer: Contains 2 arteries (carry deoxygenated blood TO placenta)
+ 1 vein (carries oxygenated blood FROM placenta to fetus).
Wharton's jelly protects vessels. Single umbilical artery = renal
anomaly risk.
◉ Amniotic Fluid.
Answer: Normal volume: 500-1000 mL at term. Functions: cushions
fetus, allows movement, maintains temp, lung development.
, Oligohydramnios (<500mL) = renal issues. Polyhydramnios
(>2000mL) = GI obstruction, diabetes, neural tube defects.
◉ Placenta Functions.
Answer: Respiration (O2/CO2 exchange), nutrition transfer, waste
elimination, hormone production (hCG, estrogen, progesterone,
HPL), immune protection (IgG transfer). Forms completely by ~12
weeks.
◉ Estrogen in Pregnancy.
Answer: Produced by placenta; stimulates uterine growth,
breast/duct development, increases uterine blood flow, stimulates
melanin production (chloasma/linea nigra), relaxes pelvic ligaments
◉ Progesterone in Pregnancy.
Answer: "Hormone of pregnancy" - maintains endometrium, relaxes
smooth muscle (↓uterine contractions, causes constipation/GERD),
prevents immune rejection of fetus, promotes breast alveolar
development
◉ hCG (Human Chorionic Gonadotropin).
Answer: Produced by trophoblast; maintains corpus luteum early
pregnancy; basis of pregnancy tests; peaks ~8-10 weeks then
declines. Elevated in multiples/molar pregnancy; low in
ectopic/miscarriage.
COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ Probable Signs of Pregnancy.
Answer: Objective signs observed by examiner: Goodell's sign,
Chadwick's sign, Hegar's sign (softening of lower uterus), positive
urine/serum pregnancy test (hCG), Braxton Hicks contractions,
ballottement, abdominal enlargement
◉ Positive Signs of Pregnancy.
Answer: Definitive confirmation of pregnancy: fetal heartbeat heard
by Doppler/fetoscope, fetal movement felt by examiner, fetal
visualization by ultrasound
◉ Goodell's Sign.
Answer: Softening of the cervix due to increased vascularity and
edema; occurs ~4-6 weeks gestation; a PROBABLE sign of
pregnancy
◉ Chadwick's Sign.
,Answer: Bluish-violet discoloration of the cervix, vagina, and vulva
due to increased blood flow/vascularity; appears ~6-8 weeks; a
PROBABLE sign of pregnancy
◉ Nagele's Rule.
Answer: Formula to calculate EDD: Take LMP → subtract 3 months
→ add 7 days → adjust year if needed. Example: LMP Oct 1 → July 1
→ July 8 = EDD
◉ GTPAL Notation.
Answer: G=Gravida (total pregnancies); T=Term births (≥37 wks);
P=Preterm births (20-36 6/7 wks); A=Abortions/miscarriages (<20
wks); L=Living children. Ex: G3T2P0A1L2
◉ Fundal Height.
Answer: Measured in cm from pubic symphysis to top of uterus;
after 20 weeks, cm ≈ weeks of gestation (±2 cm). At umbilicus = ~20
weeks. Used to assess fetal growth.
◉ Leopold's Maneuvers.
Answer: 4 systematic abdominal palpations: 1st-fundal grip (fetal
part in fundus); 2nd-lateral grip (fetal back vs extremities); 3rd-
Pawlik's grip (presenting part); 4th-pelvic grip (degree of
descent/engagement)
,◉ Fetal Movements (Kick Counts).
Answer: Patient counts fetal movements daily; report if <10
movements in 2 hours. Cardiff method: count to 10 in 12 hrs.
Decreased movement = notify provider immediately
◉ Quickening.
Answer: First maternal perception of fetal movement; primigravidas
~18-20 weeks; multigravidas ~16-18 weeks; a PRESUMPTIVE sign
of pregnancy
◉ Fetal Circulation - Key Structures.
Answer: Ductus venosus (bypasses liver), Foramen ovale (bypasses
lungs R→L atria), Ductus arteriosus (bypasses lungs pulmonary
artery→aorta). Oxygenated blood comes from placenta via umbilical
vein.
◉ Umbilical Cord Structure.
Answer: Contains 2 arteries (carry deoxygenated blood TO placenta)
+ 1 vein (carries oxygenated blood FROM placenta to fetus).
Wharton's jelly protects vessels. Single umbilical artery = renal
anomaly risk.
◉ Amniotic Fluid.
Answer: Normal volume: 500-1000 mL at term. Functions: cushions
fetus, allows movement, maintains temp, lung development.
, Oligohydramnios (<500mL) = renal issues. Polyhydramnios
(>2000mL) = GI obstruction, diabetes, neural tube defects.
◉ Placenta Functions.
Answer: Respiration (O2/CO2 exchange), nutrition transfer, waste
elimination, hormone production (hCG, estrogen, progesterone,
HPL), immune protection (IgG transfer). Forms completely by ~12
weeks.
◉ Estrogen in Pregnancy.
Answer: Produced by placenta; stimulates uterine growth,
breast/duct development, increases uterine blood flow, stimulates
melanin production (chloasma/linea nigra), relaxes pelvic ligaments
◉ Progesterone in Pregnancy.
Answer: "Hormone of pregnancy" - maintains endometrium, relaxes
smooth muscle (↓uterine contractions, causes constipation/GERD),
prevents immune rejection of fetus, promotes breast alveolar
development
◉ hCG (Human Chorionic Gonadotropin).
Answer: Produced by trophoblast; maintains corpus luteum early
pregnancy; basis of pregnancy tests; peaks ~8-10 weeks then
declines. Elevated in multiples/molar pregnancy; low in
ectopic/miscarriage.
