NSPN 7200 EVALUATION EXAM 2025/2026 QUESTIONS
WITH ANSWERS TAGGED A+
✔✔ Dizygotic twins - ✔✔Fraternal
Always have two amnions, two chorions, and two placentas that may be fused together
✔✔Monozygotic twins - ✔✔develop from one fertilized ovum (identical)
✔✔Diamniotic-Dichorionic twins - ✔✔If cell division takes place soon after fertilization,
then two placentas develop and each fetus is surrounded by its own amnion and
chorion
✔✔Monoamniotic-monochorionic twins - ✔✔If division is late, one placenta develops
with the fetuses surrounded by shared amnion and chorion
✔✔Diamniotic-monochorionic twins - ✔✔The most frequent occurrence is the
development of one placenta, two amnions, and one chorion
✔✔Most hazardous type of twinning - ✔✔A single placenta with
monochorionic/monoamniotic membranes
There is a risk of cord entanglement and increased risk of twin-to-twin transfusion
✔✔Risks of AMA - ✔✔Fetal chromosomal abnormalities, miscarriage, preterm birth,
gestational hypertension, preeclampsia, gestational diabetes, and placenta previa
✔✔Infertility - ✔✔the inability to conceive after one year of trying to become pregnant
✔✔What is the success rate of IVF related to? - ✔✔Maternal age (<35)
✔✔What are four risks associated with induction of labour? - ✔✔Tachysystole
Abnormal fetal heart rate patterns
Caesarean section
Postpartum hemorrhage (also abruption, uterine rupture, and poor fetal oxygenation).
✔✔Why should first trimester ultrasound be done in the first trimester for twins - ✔✔To
determine the size of each fetus and the number of placentas (chorionicity)
✔✔What is Twin-to-twin transfusion syndrome (TTTS)? - ✔✔A condition that occurs in
monochorionic twins sharing a placenta where one twin receives more blood supply
than the other
✔✔What are the effects on the recipient twin in TTTS? - ✔✔Fluid overload,
polyhydramnios, and polycythemia
, ✔✔What are the effects on the donor twin in TTTS? - ✔✔Growth restriction,
oligohydramnios, and anemia
✔✔Vaginal delivery likely for twins when - ✔✔Dichorionic or monochorionic/diamniotic
Twin B shouldn't be too much larger than A
Twin A must be vertex
Size between 1500-4000g
✔✔Risks of post-term pregnancy - ✔✔Increased risk of maternal/fetal morbidity and
mortality
induction of labour
dysfunctional labour
caesarean birth
fatigue/frustration
macrosomia
decreased amniotic fluid volume (oligohydramnios)
meconium aspiration
✔✔Major risk factors for stillbirth - ✔✔maternal age over 35
maternal infections
poor nutrition
GDM
modifiable factors such as smoking and obesity (90% of stillbirths)
✔✔SOGC Recommendations for Reducing Inductions - ✔✔-All women have a first
trimester ultrasound to ensure accurate dating of pregnancy
-Offer sweeping of membranes between 38 and 41 weeks gestation. Sweeping of
membranes releases endogenous prostaglandins which soften the cervix in preparation
for labour
✔✔Sweeping of membranes - ✔✔-Releases prostaglandin
-You have to be 1 cm dilated; during a VE separate membranes from cervical lining
-Starts at 38 weeks and happens weekly; twice weekly after 41 weeks
✔✔What assessments should occur twice a week after 41 wks GA - ✔✔fetal movement
counting, non-stress tests, and possibly ultrasound and/or a biophysical profile
✔✔Priority Indications for IOL - ✔✔Pre-eclampsia > 37 wks, Term PROM with GBS+
(#1 reason in Canada), chorioamnionitis, suspected fetal compromise, stable
antepartum hemorrhage, significant maternal disease, post term > 42
✔✔Secondary Indications for IOL - ✔✔Post dates (>41), oligo, IUGR, uncomp. GHTN,
uncomp. Twins >37-38, IUFD, Diabetes, AMA, Cholestasis, GBS- PROM
WITH ANSWERS TAGGED A+
✔✔ Dizygotic twins - ✔✔Fraternal
Always have two amnions, two chorions, and two placentas that may be fused together
✔✔Monozygotic twins - ✔✔develop from one fertilized ovum (identical)
✔✔Diamniotic-Dichorionic twins - ✔✔If cell division takes place soon after fertilization,
then two placentas develop and each fetus is surrounded by its own amnion and
chorion
✔✔Monoamniotic-monochorionic twins - ✔✔If division is late, one placenta develops
with the fetuses surrounded by shared amnion and chorion
✔✔Diamniotic-monochorionic twins - ✔✔The most frequent occurrence is the
development of one placenta, two amnions, and one chorion
✔✔Most hazardous type of twinning - ✔✔A single placenta with
monochorionic/monoamniotic membranes
There is a risk of cord entanglement and increased risk of twin-to-twin transfusion
✔✔Risks of AMA - ✔✔Fetal chromosomal abnormalities, miscarriage, preterm birth,
gestational hypertension, preeclampsia, gestational diabetes, and placenta previa
✔✔Infertility - ✔✔the inability to conceive after one year of trying to become pregnant
✔✔What is the success rate of IVF related to? - ✔✔Maternal age (<35)
✔✔What are four risks associated with induction of labour? - ✔✔Tachysystole
Abnormal fetal heart rate patterns
Caesarean section
Postpartum hemorrhage (also abruption, uterine rupture, and poor fetal oxygenation).
✔✔Why should first trimester ultrasound be done in the first trimester for twins - ✔✔To
determine the size of each fetus and the number of placentas (chorionicity)
✔✔What is Twin-to-twin transfusion syndrome (TTTS)? - ✔✔A condition that occurs in
monochorionic twins sharing a placenta where one twin receives more blood supply
than the other
✔✔What are the effects on the recipient twin in TTTS? - ✔✔Fluid overload,
polyhydramnios, and polycythemia
, ✔✔What are the effects on the donor twin in TTTS? - ✔✔Growth restriction,
oligohydramnios, and anemia
✔✔Vaginal delivery likely for twins when - ✔✔Dichorionic or monochorionic/diamniotic
Twin B shouldn't be too much larger than A
Twin A must be vertex
Size between 1500-4000g
✔✔Risks of post-term pregnancy - ✔✔Increased risk of maternal/fetal morbidity and
mortality
induction of labour
dysfunctional labour
caesarean birth
fatigue/frustration
macrosomia
decreased amniotic fluid volume (oligohydramnios)
meconium aspiration
✔✔Major risk factors for stillbirth - ✔✔maternal age over 35
maternal infections
poor nutrition
GDM
modifiable factors such as smoking and obesity (90% of stillbirths)
✔✔SOGC Recommendations for Reducing Inductions - ✔✔-All women have a first
trimester ultrasound to ensure accurate dating of pregnancy
-Offer sweeping of membranes between 38 and 41 weeks gestation. Sweeping of
membranes releases endogenous prostaglandins which soften the cervix in preparation
for labour
✔✔Sweeping of membranes - ✔✔-Releases prostaglandin
-You have to be 1 cm dilated; during a VE separate membranes from cervical lining
-Starts at 38 weeks and happens weekly; twice weekly after 41 weeks
✔✔What assessments should occur twice a week after 41 wks GA - ✔✔fetal movement
counting, non-stress tests, and possibly ultrasound and/or a biophysical profile
✔✔Priority Indications for IOL - ✔✔Pre-eclampsia > 37 wks, Term PROM with GBS+
(#1 reason in Canada), chorioamnionitis, suspected fetal compromise, stable
antepartum hemorrhage, significant maternal disease, post term > 42
✔✔Secondary Indications for IOL - ✔✔Post dates (>41), oligo, IUGR, uncomp. GHTN,
uncomp. Twins >37-38, IUFD, Diabetes, AMA, Cholestasis, GBS- PROM
