,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. Number of pregnancies reaching viability
B. Number of deliveries after 24 weeks
C. Total number of times a woman has been pregnant, regardless of outcome
D. Number of living children
E. Number of pregnancies resulting in live birth
✅ Correct Answer: C. Total number of times a woman has been pregnant,
regardless of outcome
📖 Rationale: Gravidity refers to the total number of times a woman has been pregnant,
irrespective of the outcome of those pregnancies, including miscarriages, ectopic
pregnancies, and terminations. This definition is fundamental in obstetric history-taking
and ensures comprehensive documentation of reproductive history. It differs from
parity, which only accounts for pregnancies reaching viability. Accurate distinction
between gravidity and parity is critical for clinical risk assessment and antenatal care
planning.
Question 2 | Type: MCQ-Recall | Cognitive Level: Recall
In obstetric notation, which of the following is included in the calculation of parity?
A. Ectopic pregnancies
B. Miscarriages before viability
C. Pregnancies reaching viability regardless of outcome
D. Biochemical pregnancies only
E. Terminations before 12 weeks
✅ Correct Answer: C. Pregnancies reaching viability regardless of outcome
,📖 Rationale: Parity refers to the number of pregnancies that have reached the
threshold of viability, regardless of whether the fetus was born alive or stillborn. This
definition is important because it reflects the physiological burden of advanced
pregnancy on the maternal body. Miscarriages and early terminations before viability
are not included in parity. This distinction is crucial for assessing obstetric risk and
planning appropriate antenatal surveillance.
Question 3 | Type: MCQ-Recall | Cognitive Level: Recall
During abdominal palpation in pregnancy, which maneuver is primarily used to
determine fetal presentation?
A. Fundal height measurement
B. First Leopold’s maneuver
C. Second Leopold’s maneuver
D. Third Leopold’s maneuver
E. Auscultation of fetal heart
✅ Correct Answer: D. Third Leopold’s maneuver
📖 Rationale: The third Leopold’s maneuver is specifically used to identify the
presenting part of the fetus by palpating just above the symphysis pubis. This helps
determine whether the presenting part is cephalic or breech and assesses its mobility.
Accurate identification of presentation is essential for labour planning and risk
assessment. It complements the other maneuvers, which assess lie and fetal position.
Question 4 | Type: MCQ-Recall | Cognitive Level: Recall
What is the expected symphysis-fundal height (SFH) in centimeters at 28 weeks of
gestation in a normal singleton pregnancy?
A. 20 cm
B. 24 cm
C. 28 cm
D. 32 cm
E. 36 cm
,✅ Correct Answer: C. 28 cm
📖 Rationale: From approximately 24 to 36 weeks of gestation, the symphysis-fundal
height in centimeters roughly corresponds to the gestational age in weeks. Therefore, at
28 weeks, an SFH of approximately 28 cm is expected. This simple clinical tool is widely
used to monitor fetal growth and identify deviations such as intrauterine growth
restriction or macrosomia. Consistent measurement technique is essential to ensure
accuracy and reliability.
Question 5 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
Why is a comprehensive social history important during the booking visit in pregnancy?
A. To determine fetal sex early
B. To estimate gestational age
C. To identify psychosocial risk factors affecting pregnancy outcomes
D. To diagnose fetal anomalies
E. To determine mode of delivery
✅ Correct Answer: C. To identify psychosocial risk factors affecting pregnancy
outcomes
📖 Rationale: Social history provides insight into factors such as housing, support
systems, substance use, and domestic circumstances, all of which can significantly
impact maternal and fetal outcomes. Identifying psychosocial risks allows for early
intervention and multidisciplinary support. The booking visit is a critical opportunity to
detect vulnerabilities that may otherwise go unnoticed. Addressing these factors
improves overall pregnancy care and reduces adverse outcomes.
Question 6 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
What is the clinical significance of assessing fetal lie during abdominal examination?
A. Determines placental location
B. Assesses amniotic fluid volume
C. Identifies the relationship of fetal long axis to maternal spine
,D. Measures fetal weight
E. Predicts fetal anomalies
✅ Correct Answer: C. Identifies the relationship of fetal long axis to maternal spine
📖 Rationale: Fetal lie describes the relationship between the long axis of the fetus and
that of the mother, which can be longitudinal, transverse, or oblique. This assessment is
crucial for anticipating potential complications during labour, particularly
malpresentation. A non-longitudinal lie near term may necessitate intervention.
Understanding fetal lie guides further examination and informs decisions regarding
delivery planning.
Question 7 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
Why is it important to standardize the technique of SFH measurement?
A. To reduce patient discomfort
B. To allow comparison with population norms and detect growth abnormalities
C. To shorten examination time
D. To improve fetal heart rate detection
E. To determine fetal position
✅ Correct Answer: B. To allow comparison with population norms and detect
growth abnormalities
📖 Rationale: Standardization of SFH measurement ensures consistency and accuracy,
allowing clinicians to compare results against expected gestational norms. This is
essential for detecting deviations such as fetal growth restriction or excessive growth.
Variability in technique can lead to misleading results and inappropriate clinical
decisions. Therefore, adherence to proper measurement protocols is critical in antenatal
care.
Question 8 | Type: MCQ-Application | Cognitive Level: Application
A 28-year-old G3P1+1 woman attends her booking visit at 10 weeks’ gestation. Her
history includes one term delivery and one miscarriage at 10 weeks. How should her
obstetric score be recorded?
,A. G2P1
B. G3P1
C. G3P2
D. G2P2
E. G3P1+1
✅ Correct Answer: E. G3P1+1
📖 Rationale: This woman has had three pregnancies in total (gravidity = 3), including
her current pregnancy. She has had one pregnancy reaching viability (parity = 1) and
one miscarriage, which is often recorded separately as “+1.” This notation provides a
more detailed reproductive history. Accurate recording is essential for identifying risk
factors and guiding antenatal care.
Question 9 | Type: MCQ-Application | Cognitive Level: Application
A 32-week pregnant woman has an SFH of 26 cm. What is the most appropriate next
step?
A. Reassure and continue routine care
B. Immediate induction of labour
C. Repeat measurement and consider further assessment for fetal growth restriction
D. Perform vaginal examination
E. Start antibiotics
✅ Correct Answer: C. Repeat measurement and consider further assessment for
fetal growth restriction
📖 Rationale: An SFH measurement significantly lower than expected for gestational
age suggests possible fetal growth restriction. The first step is to confirm the finding
with repeat measurement and then consider further investigations such as ultrasound.
Early identification allows timely intervention and improved outcomes. Routine
reassurance without evaluation may delay diagnosis of a potentially serious condition.
Question 10 | Type: MCQ-Application | Cognitive Level: Application
, A pregnant woman at 38 weeks is found to have a breech presentation on abdominal
examination. Which finding most likely led to this conclusion?
A. Fetal back palpated laterally
B. Hard round mass in the fundus
C. Soft irregular mass in the lower abdomen
D. Fetal heart heard above the umbilicus
E. SFH greater than expected
✅ Correct Answer: D. Fetal heart heard above the umbilicus
📖 Rationale: In breech presentation, the fetal head is located in the fundus, and the
fetal heart is typically heard above the umbilicus. This contrasts with cephalic
presentation, where the fetal heart is usually heard below the umbilicus. This clinical sign
supports findings from palpation and helps confirm presentation. Accurate identification
is essential for delivery planning.
Question 11 | Type: MCQ-Analysis | Cognitive Level: Analysis
A 25-year-old primigravida at 40 weeks presents with irregular contractions. Vaginal
examination reveals a Bishop score of 3. What does this indicate?
A. Cervix is favourable for induction
B. Labour is imminent
C. Cervix is unfavourable and induction may be less successful
D. Immediate delivery is required
E. Fetal distress is present
✅ Correct Answer: C. Cervix is unfavourable and induction may be less successful
📖 Rationale: The Bishop score assesses cervical readiness for labour based on dilation,
effacement, consistency, position, and fetal station. A low score (≤5) indicates an
unfavourable cervix, suggesting that induction of labour may be less likely to succeed
without cervical ripening. This informs clinical decision-making and planning of
induction methods. Understanding the Bishop score is critical for safe labour
management.
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. Number of pregnancies reaching viability
B. Number of deliveries after 24 weeks
C. Total number of times a woman has been pregnant, regardless of outcome
D. Number of living children
E. Number of pregnancies resulting in live birth
✅ Correct Answer: C. Total number of times a woman has been pregnant,
regardless of outcome
📖 Rationale: Gravidity refers to the total number of times a woman has been pregnant,
irrespective of the outcome of those pregnancies, including miscarriages, ectopic
pregnancies, and terminations. This definition is fundamental in obstetric history-taking
and ensures comprehensive documentation of reproductive history. It differs from
parity, which only accounts for pregnancies reaching viability. Accurate distinction
between gravidity and parity is critical for clinical risk assessment and antenatal care
planning.
Question 2 | Type: MCQ-Recall | Cognitive Level: Recall
In obstetric notation, which of the following is included in the calculation of parity?
A. Ectopic pregnancies
B. Miscarriages before viability
C. Pregnancies reaching viability regardless of outcome
D. Biochemical pregnancies only
E. Terminations before 12 weeks
✅ Correct Answer: C. Pregnancies reaching viability regardless of outcome
,📖 Rationale: Parity refers to the number of pregnancies that have reached the
threshold of viability, regardless of whether the fetus was born alive or stillborn. This
definition is important because it reflects the physiological burden of advanced
pregnancy on the maternal body. Miscarriages and early terminations before viability
are not included in parity. This distinction is crucial for assessing obstetric risk and
planning appropriate antenatal surveillance.
Question 3 | Type: MCQ-Recall | Cognitive Level: Recall
During abdominal palpation in pregnancy, which maneuver is primarily used to
determine fetal presentation?
A. Fundal height measurement
B. First Leopold’s maneuver
C. Second Leopold’s maneuver
D. Third Leopold’s maneuver
E. Auscultation of fetal heart
✅ Correct Answer: D. Third Leopold’s maneuver
📖 Rationale: The third Leopold’s maneuver is specifically used to identify the
presenting part of the fetus by palpating just above the symphysis pubis. This helps
determine whether the presenting part is cephalic or breech and assesses its mobility.
Accurate identification of presentation is essential for labour planning and risk
assessment. It complements the other maneuvers, which assess lie and fetal position.
Question 4 | Type: MCQ-Recall | Cognitive Level: Recall
What is the expected symphysis-fundal height (SFH) in centimeters at 28 weeks of
gestation in a normal singleton pregnancy?
A. 20 cm
B. 24 cm
C. 28 cm
D. 32 cm
E. 36 cm
,✅ Correct Answer: C. 28 cm
📖 Rationale: From approximately 24 to 36 weeks of gestation, the symphysis-fundal
height in centimeters roughly corresponds to the gestational age in weeks. Therefore, at
28 weeks, an SFH of approximately 28 cm is expected. This simple clinical tool is widely
used to monitor fetal growth and identify deviations such as intrauterine growth
restriction or macrosomia. Consistent measurement technique is essential to ensure
accuracy and reliability.
Question 5 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
Why is a comprehensive social history important during the booking visit in pregnancy?
A. To determine fetal sex early
B. To estimate gestational age
C. To identify psychosocial risk factors affecting pregnancy outcomes
D. To diagnose fetal anomalies
E. To determine mode of delivery
✅ Correct Answer: C. To identify psychosocial risk factors affecting pregnancy
outcomes
📖 Rationale: Social history provides insight into factors such as housing, support
systems, substance use, and domestic circumstances, all of which can significantly
impact maternal and fetal outcomes. Identifying psychosocial risks allows for early
intervention and multidisciplinary support. The booking visit is a critical opportunity to
detect vulnerabilities that may otherwise go unnoticed. Addressing these factors
improves overall pregnancy care and reduces adverse outcomes.
Question 6 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
What is the clinical significance of assessing fetal lie during abdominal examination?
A. Determines placental location
B. Assesses amniotic fluid volume
C. Identifies the relationship of fetal long axis to maternal spine
,D. Measures fetal weight
E. Predicts fetal anomalies
✅ Correct Answer: C. Identifies the relationship of fetal long axis to maternal spine
📖 Rationale: Fetal lie describes the relationship between the long axis of the fetus and
that of the mother, which can be longitudinal, transverse, or oblique. This assessment is
crucial for anticipating potential complications during labour, particularly
malpresentation. A non-longitudinal lie near term may necessitate intervention.
Understanding fetal lie guides further examination and informs decisions regarding
delivery planning.
Question 7 | Type: MCQ-Comprehension | Cognitive Level: Comprehension
Why is it important to standardize the technique of SFH measurement?
A. To reduce patient discomfort
B. To allow comparison with population norms and detect growth abnormalities
C. To shorten examination time
D. To improve fetal heart rate detection
E. To determine fetal position
✅ Correct Answer: B. To allow comparison with population norms and detect
growth abnormalities
📖 Rationale: Standardization of SFH measurement ensures consistency and accuracy,
allowing clinicians to compare results against expected gestational norms. This is
essential for detecting deviations such as fetal growth restriction or excessive growth.
Variability in technique can lead to misleading results and inappropriate clinical
decisions. Therefore, adherence to proper measurement protocols is critical in antenatal
care.
Question 8 | Type: MCQ-Application | Cognitive Level: Application
A 28-year-old G3P1+1 woman attends her booking visit at 10 weeks’ gestation. Her
history includes one term delivery and one miscarriage at 10 weeks. How should her
obstetric score be recorded?
,A. G2P1
B. G3P1
C. G3P2
D. G2P2
E. G3P1+1
✅ Correct Answer: E. G3P1+1
📖 Rationale: This woman has had three pregnancies in total (gravidity = 3), including
her current pregnancy. She has had one pregnancy reaching viability (parity = 1) and
one miscarriage, which is often recorded separately as “+1.” This notation provides a
more detailed reproductive history. Accurate recording is essential for identifying risk
factors and guiding antenatal care.
Question 9 | Type: MCQ-Application | Cognitive Level: Application
A 32-week pregnant woman has an SFH of 26 cm. What is the most appropriate next
step?
A. Reassure and continue routine care
B. Immediate induction of labour
C. Repeat measurement and consider further assessment for fetal growth restriction
D. Perform vaginal examination
E. Start antibiotics
✅ Correct Answer: C. Repeat measurement and consider further assessment for
fetal growth restriction
📖 Rationale: An SFH measurement significantly lower than expected for gestational
age suggests possible fetal growth restriction. The first step is to confirm the finding
with repeat measurement and then consider further investigations such as ultrasound.
Early identification allows timely intervention and improved outcomes. Routine
reassurance without evaluation may delay diagnosis of a potentially serious condition.
Question 10 | Type: MCQ-Application | Cognitive Level: Application
, A pregnant woman at 38 weeks is found to have a breech presentation on abdominal
examination. Which finding most likely led to this conclusion?
A. Fetal back palpated laterally
B. Hard round mass in the fundus
C. Soft irregular mass in the lower abdomen
D. Fetal heart heard above the umbilicus
E. SFH greater than expected
✅ Correct Answer: D. Fetal heart heard above the umbilicus
📖 Rationale: In breech presentation, the fetal head is located in the fundus, and the
fetal heart is typically heard above the umbilicus. This contrasts with cephalic
presentation, where the fetal heart is usually heard below the umbilicus. This clinical sign
supports findings from palpation and helps confirm presentation. Accurate identification
is essential for delivery planning.
Question 11 | Type: MCQ-Analysis | Cognitive Level: Analysis
A 25-year-old primigravida at 40 weeks presents with irregular contractions. Vaginal
examination reveals a Bishop score of 3. What does this indicate?
A. Cervix is favourable for induction
B. Labour is imminent
C. Cervix is unfavourable and induction may be less successful
D. Immediate delivery is required
E. Fetal distress is present
✅ Correct Answer: C. Cervix is unfavourable and induction may be less successful
📖 Rationale: The Bishop score assesses cervical readiness for labour based on dilation,
effacement, consistency, position, and fetal station. A low score (≤5) indicates an
unfavourable cervix, suggesting that induction of labour may be less likely to succeed
without cervical ripening. This informs clinical decision-making and planning of
induction methods. Understanding the Bishop score is critical for safe labour
management.
