OB FINAL EXAM CERTIFICATION TEST 2026
QUESTIONS AND VERIFIED ANSWERS ALREADY
PASSED
◉ 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.
◉ Human Placental Lactogen (hPL).
Answer: Produced by placenta; antagonizes insulin (causes insulin
resistance) → gestational diabetes risk; promotes fetal growth and
maternal fat mobilization for fetal fuel
◉ First Stage of Labor.
Answer: Onset of regular contractions → complete cervical dilation
(10 cm). Phases: Latent (0-6 cm, slow), Active (6-10 cm, faster
~1cm/hr), Transition (~8-10 cm, intense). Longest stage.
◉ Second Stage of Labor.
,Answer: Complete cervical dilation (10 cm) → delivery of baby.
Pushing phase. Average: primipara ~2 hrs, multipara ~1 hr. Fetal HR
monitored closely; pushing with contractions.
◉ Third Stage of Labor.
Answer: Delivery of baby → delivery of placenta. Signs of placental
separation: gush of blood, uterus rises/firms, cord lengthens. Deliver
within 30 min; manual removal if retained.
◉ Fourth Stage of Labor.
Answer: First 1-4 hours postpartum. Monitor for hemorrhage: VS
q15 min x1hr, fundus firm/midline, lochia, bladder distension. High
risk for PPH. Maternal-infant bonding begins.
◉ Seven Cardinal Movements of Labor.
Answer: 1-Engagement, 2-Descent, 3-Flexion, 4-Internal Rotation, 5-
Extension (delivery of head), 6-External Rotation (restitution), 7-
Expulsion (delivery of shoulders/body)
◉ Placenta Previa.
Answer: Placenta implanted over/near cervical os. Painless, bright
red vaginal bleeding, NO vaginal exams. Types: complete, partial,
marginal. Management: bedrest, C-section if complete. Monitor for
hemorrhage.
, ◉ Abruptio Placentae.
Answer: Premature separation of normally implanted placenta.
Signs: painful dark red bleeding, rigid/board-like abdomen, uterine
tenderness, fetal distress. Risk factors: HTN, cocaine, trauma, prior
abruption. Emergency!
◉ DIC (Disseminated Intravascular Coagulation).
Answer: Coagulation disorder: clotting factors consumed →
simultaneous clotting AND bleeding. Triggered by: abruption, sepsis,
amniotic fluid embolism. Signs: oozing from IV sites, petechiae,
hematuria. Tx: treat cause, FFP, platelets.
◉ Vena Cava Syndrome (Supine Hypotensive Syndrome).
Answer: Compression of inferior vena cava by gravid uterus when
supine → ↓venous return → ↓BP, dizziness, fetal distress.
Intervention: position in LEFT LATERAL position, avoid supine
especially after 20 weeks.
◉ Multiple Gestation.
Answer: Twins/multiples. Higher risk: preterm labor, IUGR, placenta
previa, PPH, malpresentation. Dizygotic (fraternal) = 2 eggs+2
sperm; Monozygotic (identical) = 1 egg splits. Mono/mono highest
risk.
◉ Fetal Heart Rate - Normal.
QUESTIONS AND VERIFIED ANSWERS ALREADY
PASSED
◉ 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.
◉ Human Placental Lactogen (hPL).
Answer: Produced by placenta; antagonizes insulin (causes insulin
resistance) → gestational diabetes risk; promotes fetal growth and
maternal fat mobilization for fetal fuel
◉ First Stage of Labor.
Answer: Onset of regular contractions → complete cervical dilation
(10 cm). Phases: Latent (0-6 cm, slow), Active (6-10 cm, faster
~1cm/hr), Transition (~8-10 cm, intense). Longest stage.
◉ Second Stage of Labor.
,Answer: Complete cervical dilation (10 cm) → delivery of baby.
Pushing phase. Average: primipara ~2 hrs, multipara ~1 hr. Fetal HR
monitored closely; pushing with contractions.
◉ Third Stage of Labor.
Answer: Delivery of baby → delivery of placenta. Signs of placental
separation: gush of blood, uterus rises/firms, cord lengthens. Deliver
within 30 min; manual removal if retained.
◉ Fourth Stage of Labor.
Answer: First 1-4 hours postpartum. Monitor for hemorrhage: VS
q15 min x1hr, fundus firm/midline, lochia, bladder distension. High
risk for PPH. Maternal-infant bonding begins.
◉ Seven Cardinal Movements of Labor.
Answer: 1-Engagement, 2-Descent, 3-Flexion, 4-Internal Rotation, 5-
Extension (delivery of head), 6-External Rotation (restitution), 7-
Expulsion (delivery of shoulders/body)
◉ Placenta Previa.
Answer: Placenta implanted over/near cervical os. Painless, bright
red vaginal bleeding, NO vaginal exams. Types: complete, partial,
marginal. Management: bedrest, C-section if complete. Monitor for
hemorrhage.
, ◉ Abruptio Placentae.
Answer: Premature separation of normally implanted placenta.
Signs: painful dark red bleeding, rigid/board-like abdomen, uterine
tenderness, fetal distress. Risk factors: HTN, cocaine, trauma, prior
abruption. Emergency!
◉ DIC (Disseminated Intravascular Coagulation).
Answer: Coagulation disorder: clotting factors consumed →
simultaneous clotting AND bleeding. Triggered by: abruption, sepsis,
amniotic fluid embolism. Signs: oozing from IV sites, petechiae,
hematuria. Tx: treat cause, FFP, platelets.
◉ Vena Cava Syndrome (Supine Hypotensive Syndrome).
Answer: Compression of inferior vena cava by gravid uterus when
supine → ↓venous return → ↓BP, dizziness, fetal distress.
Intervention: position in LEFT LATERAL position, avoid supine
especially after 20 weeks.
◉ Multiple Gestation.
Answer: Twins/multiples. Higher risk: preterm labor, IUGR, placenta
previa, PPH, malpresentation. Dizygotic (fraternal) = 2 eggs+2
sperm; Monozygotic (identical) = 1 egg splits. Mono/mono highest
risk.
◉ Fetal Heart Rate - Normal.
