AMCB Midwifery Exam Q&A 2025/2026: Verified Answers &
Rationales, Exams of Medicine
Latent Phase of Labor - ANSWEROnset of labor until cervical dilation reaches 4-6 m
Long arc rotation - ANSWERMost commonly performed by babies beginning labor in
LOP presentation
FHR Variability: controlling system - ANSWERParasympathetic/sympathetic nervous
system
Pudendal Anesthesia Administration - ANSWERIdeal timing to administer in multip
women is at 8-9cm, just before complete dilation, to cover birth and repair
Sudden fetal bradycardia in 2nd stage - ANSWERcommonly caused by a vagal response
in the fetus related to descent
Engagement occurs when - ANSWERWidest diameter of the presenting part descends
to or below the pelvic inlet
The widest diameter of the fetal head is the biparietal diameter
Iron Deficiency Labs - ANSWERMicrocytic, hypochromic
Low Hgb, Hct, MCV, MCHC, RBCs, iron, ferritin
High TIBC
High RDW
,Leg cramp in pregnancy relief - ANSWERFlexion of the foot
Changes in respiratory system in pregnancy - ANSWERMay cause increased chest
diameter; thoracic circumference increases by 5-6cm and residual volume decreases
polyhydramnios fetal etiology - ANSWERCNS or GI tract fetal anomalies
Autosomal Recessive Trai - ANSWERExpressed only when both copies of the gene are
the same; ex cystic fibrosis and sickle cell anemia
Infant effects of maternal tobacco use - ANSWERIUGR, premature birth, and SGA
Severe features of preeclampsia - ANSWERthrombocytopenia, renal insufficiency,
impaired liver function, pulmonary edema, and cerebral or visual symptoms
Hemodynamic Changes in Initial Postpartum Period - ANSWERElevated cardiac
output for as long as 48 hours after birth; cardiac output increases 60-80%
Placental transport of oxygen and glucose - ANSWERTransported across the placenta
via facilitated diffusion
Amniotic fluid production - ANSWERProduced by the amniotic epithelium; water
transfers across the amnion and through the fetal skin
-in the 2nd trimester, the fetus starts to swallow, urinate, and inspire amniotic fluid
Trichomoniasis treatment in Pregnancy - ANSWERMetronidazole (Flagyl) 2 g PO x1 at
any stage in pregnancy
,Ritgen maneuver - ANSWERAssist in delivery of the fetal head during extension
Used to expedite the delivery of the fetal head when necessary
It involves applying upward pressure from the coccygeal region to extend the head
during actual delivery, thereby protecting the musculature of the perineum.
Maternal breastfeeding contraindications - ANSWERHIV positive and untreated
Active TB
Illicit drug use
Take prescribed chemotherapy agents
Acrocyanosis - ANSWERBluish discoloration of the hands and feet caused by reduced
peripheral circulation.
Normal within first 24-48 hours after birth
Variable decelerations description - ANSWERAbrupt in nature
Decrease in FHR from a baseline of >15BPM lasting >15 seconds but <2 min
Anterior asynclitism - ANSWERexists when the sagittal suture is closer to the sacrum
and the anterior parietal bone is presenting first
Oligohydramnios fetal etiology - ANSWERAssociated with genitourinary abnormalities
in the fetus
Midplane Definition/Elements - ANSWERIschial spines distance and sacrum
Distance b/w the ischial spines normally measures 10 cm
Smallest diameter of the pelvis
, Chorionic Villi - ANSWERThe chorionic villi develop from the outer wall of the
blastocyst which establishes and intimate connection with the endometrium and gives
rise to the placenta
Blood in the chorionic villi pertains to the circulation of the fetus
Umbilical Cord Vessels - ANSWER2 arteries that carry fetal deoxygenated blood to the
placenta, smaller in diameter
1 vein that carries oxygenated blood from the placenta to the fetus; characterized by
twisting or spiralizing
Implantation - ANSWEROccurs 6-7 days after fertilization
Usually in the upper posterior wall of the uterus
Human zygote - ANSWERconsists of haploid number of chromosomes; 23 pairs
Possesses half the diploid or number of pairs of chromosomes, 46 pairs, found in
somatic, or body cells
Trophoblast - ANSWERThe outer layer of cells that develops in the germinal period.
These cells provide nutrition and support for the embryo.
Ultimately becomes the placenta
Drop in diastolic BP during normal pregnancy - ANSWERLower in the first 2 trimesters
because of the development of new vascular beds and the relaxation of peripheral tone
by progesterone, which result in decreased flow resistance
Nullipara - ANSWERwomen who has not carried a baby to 500g or 20 weeks
Rationales, Exams of Medicine
Latent Phase of Labor - ANSWEROnset of labor until cervical dilation reaches 4-6 m
Long arc rotation - ANSWERMost commonly performed by babies beginning labor in
LOP presentation
FHR Variability: controlling system - ANSWERParasympathetic/sympathetic nervous
system
Pudendal Anesthesia Administration - ANSWERIdeal timing to administer in multip
women is at 8-9cm, just before complete dilation, to cover birth and repair
Sudden fetal bradycardia in 2nd stage - ANSWERcommonly caused by a vagal response
in the fetus related to descent
Engagement occurs when - ANSWERWidest diameter of the presenting part descends
to or below the pelvic inlet
The widest diameter of the fetal head is the biparietal diameter
Iron Deficiency Labs - ANSWERMicrocytic, hypochromic
Low Hgb, Hct, MCV, MCHC, RBCs, iron, ferritin
High TIBC
High RDW
,Leg cramp in pregnancy relief - ANSWERFlexion of the foot
Changes in respiratory system in pregnancy - ANSWERMay cause increased chest
diameter; thoracic circumference increases by 5-6cm and residual volume decreases
polyhydramnios fetal etiology - ANSWERCNS or GI tract fetal anomalies
Autosomal Recessive Trai - ANSWERExpressed only when both copies of the gene are
the same; ex cystic fibrosis and sickle cell anemia
Infant effects of maternal tobacco use - ANSWERIUGR, premature birth, and SGA
Severe features of preeclampsia - ANSWERthrombocytopenia, renal insufficiency,
impaired liver function, pulmonary edema, and cerebral or visual symptoms
Hemodynamic Changes in Initial Postpartum Period - ANSWERElevated cardiac
output for as long as 48 hours after birth; cardiac output increases 60-80%
Placental transport of oxygen and glucose - ANSWERTransported across the placenta
via facilitated diffusion
Amniotic fluid production - ANSWERProduced by the amniotic epithelium; water
transfers across the amnion and through the fetal skin
-in the 2nd trimester, the fetus starts to swallow, urinate, and inspire amniotic fluid
Trichomoniasis treatment in Pregnancy - ANSWERMetronidazole (Flagyl) 2 g PO x1 at
any stage in pregnancy
,Ritgen maneuver - ANSWERAssist in delivery of the fetal head during extension
Used to expedite the delivery of the fetal head when necessary
It involves applying upward pressure from the coccygeal region to extend the head
during actual delivery, thereby protecting the musculature of the perineum.
Maternal breastfeeding contraindications - ANSWERHIV positive and untreated
Active TB
Illicit drug use
Take prescribed chemotherapy agents
Acrocyanosis - ANSWERBluish discoloration of the hands and feet caused by reduced
peripheral circulation.
Normal within first 24-48 hours after birth
Variable decelerations description - ANSWERAbrupt in nature
Decrease in FHR from a baseline of >15BPM lasting >15 seconds but <2 min
Anterior asynclitism - ANSWERexists when the sagittal suture is closer to the sacrum
and the anterior parietal bone is presenting first
Oligohydramnios fetal etiology - ANSWERAssociated with genitourinary abnormalities
in the fetus
Midplane Definition/Elements - ANSWERIschial spines distance and sacrum
Distance b/w the ischial spines normally measures 10 cm
Smallest diameter of the pelvis
, Chorionic Villi - ANSWERThe chorionic villi develop from the outer wall of the
blastocyst which establishes and intimate connection with the endometrium and gives
rise to the placenta
Blood in the chorionic villi pertains to the circulation of the fetus
Umbilical Cord Vessels - ANSWER2 arteries that carry fetal deoxygenated blood to the
placenta, smaller in diameter
1 vein that carries oxygenated blood from the placenta to the fetus; characterized by
twisting or spiralizing
Implantation - ANSWEROccurs 6-7 days after fertilization
Usually in the upper posterior wall of the uterus
Human zygote - ANSWERconsists of haploid number of chromosomes; 23 pairs
Possesses half the diploid or number of pairs of chromosomes, 46 pairs, found in
somatic, or body cells
Trophoblast - ANSWERThe outer layer of cells that develops in the germinal period.
These cells provide nutrition and support for the embryo.
Ultimately becomes the placenta
Drop in diastolic BP during normal pregnancy - ANSWERLower in the first 2 trimesters
because of the development of new vascular beds and the relaxation of peripheral tone
by progesterone, which result in decreased flow resistance
Nullipara - ANSWERwomen who has not carried a baby to 500g or 20 weeks
