LATEST OBSTETRICS & GYNECOLOGY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 28-year-old G1P0 at 39 weeks gestation presents
with painful, regular contractions every 2-3 minutes.
Cervical exam is 6 cm, 90% effaced, vertex at 0
station. Fetal heart rate tracing shows a sinusoidal
pattern. What is the most appropriate next step?
A) Immediate cesarean delivery
B) Intrauterine resuscitation and observation
C) Amnioinfusion
D) Scalp stimulation
Correct answer: A
Rationale: A sinusoidal fetal heart rate pattern is
associated with severe fetal anemia (e.g.,
fetomaternal hemorrhage, isoimmunization) and
requires immediate delivery.
2. A 32-year-old G2P1 at 28 weeks gestation presents
with painless vaginal bleeding. Ultrasound shows
placenta previa covering the internal os. She is
,hemodynamically stable. What is the most
appropriate next step?
A) Hospital admission with expectant management
B) Outpatient follow-up with pelvic rest
C) Cesarean delivery
D) Digital cervical exam to rule out placental previa
Correct answer: A
Rationale: Placenta previa with bleeding after 24
weeks requires hospital admission for monitoring,
corticosteroids for fetal lung maturity, and expectant
management until 36-37 weeks.
3. A 25-year-old G1P0 at 41 weeks gestation
undergoes induction of labor with oxytocin. She
develops a contraction lasting 3 minutes with a non-
reassuring fetal heart rate pattern (bradycardia).
What is the most appropriate next step?
A) Discontinue oxytocin, reposition patient, give
oxygen, IV fluids
B) Increase oxytocin to augment labor
C) Immediate cesarean delivery
D) Administer terbutaline
Correct answer: A
,Rationale: Tetanic contraction with fetal bradycardia
requires stopping oxytocin, repositioning (left
lateral), oxygen, and IV fluids. Terbutaline (tocolysis)
if no improvement.
4. A 30-year-old G3P2 at 38 weeks gestation presents
with a history of prior cesarean delivery (low
transverse). She desires a trial of labor after
cesarean (TOLAC). Which of the following is an
absolute contraindication to TOLAC?
A) Prior classical (vertical) uterine incision
B) Prior low transverse incision
C) Two prior cesarean deliveries
D) Maternal obesity
Correct answer: A
Rationale: A prior classical (vertical) uterine incision
carries a high risk of uterine rupture and is an
absolute contraindication to TOLAC.
5. A 22-year-old G1P0 at 36 weeks gestation presents
with severe epigastric pain, nausea, and headache.
Blood pressure is 160/100, urine protein is 3+ (300
mg/dL). Platelet count is 80,000. What is the most
appropriate next step?
, A) Magnesium sulfate and immediate delivery
(cesarean or induction)
B) Labetalol for blood pressure control and
outpatient follow-up
C) Expectant management until 37 weeks
D) IV hydralazine and discharge
Correct answer: A
Rationale: This patient has severe preeclampsia with
HELLP syndrome (thrombocytopenia, epigastric
pain). Delivery is indicated regardless of gestational
age after 34 weeks.
6. A 35-year-old G3P2 at 32 weeks gestation presents
with preterm premature rupture of membranes
(PPROM). She is afebrile with no uterine tenderness.
Ultrasound shows oligohydramnios. What is the most
appropriate next step?
A) Hospital admission, corticosteroids, and expectant
management
B) Immediate delivery (induction or cesarean)
C) Outpatient antibiotics
D) Amnioinfusion
Correct answer: A
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 28-year-old G1P0 at 39 weeks gestation presents
with painful, regular contractions every 2-3 minutes.
Cervical exam is 6 cm, 90% effaced, vertex at 0
station. Fetal heart rate tracing shows a sinusoidal
pattern. What is the most appropriate next step?
A) Immediate cesarean delivery
B) Intrauterine resuscitation and observation
C) Amnioinfusion
D) Scalp stimulation
Correct answer: A
Rationale: A sinusoidal fetal heart rate pattern is
associated with severe fetal anemia (e.g.,
fetomaternal hemorrhage, isoimmunization) and
requires immediate delivery.
2. A 32-year-old G2P1 at 28 weeks gestation presents
with painless vaginal bleeding. Ultrasound shows
placenta previa covering the internal os. She is
,hemodynamically stable. What is the most
appropriate next step?
A) Hospital admission with expectant management
B) Outpatient follow-up with pelvic rest
C) Cesarean delivery
D) Digital cervical exam to rule out placental previa
Correct answer: A
Rationale: Placenta previa with bleeding after 24
weeks requires hospital admission for monitoring,
corticosteroids for fetal lung maturity, and expectant
management until 36-37 weeks.
3. A 25-year-old G1P0 at 41 weeks gestation
undergoes induction of labor with oxytocin. She
develops a contraction lasting 3 minutes with a non-
reassuring fetal heart rate pattern (bradycardia).
What is the most appropriate next step?
A) Discontinue oxytocin, reposition patient, give
oxygen, IV fluids
B) Increase oxytocin to augment labor
C) Immediate cesarean delivery
D) Administer terbutaline
Correct answer: A
,Rationale: Tetanic contraction with fetal bradycardia
requires stopping oxytocin, repositioning (left
lateral), oxygen, and IV fluids. Terbutaline (tocolysis)
if no improvement.
4. A 30-year-old G3P2 at 38 weeks gestation presents
with a history of prior cesarean delivery (low
transverse). She desires a trial of labor after
cesarean (TOLAC). Which of the following is an
absolute contraindication to TOLAC?
A) Prior classical (vertical) uterine incision
B) Prior low transverse incision
C) Two prior cesarean deliveries
D) Maternal obesity
Correct answer: A
Rationale: A prior classical (vertical) uterine incision
carries a high risk of uterine rupture and is an
absolute contraindication to TOLAC.
5. A 22-year-old G1P0 at 36 weeks gestation presents
with severe epigastric pain, nausea, and headache.
Blood pressure is 160/100, urine protein is 3+ (300
mg/dL). Platelet count is 80,000. What is the most
appropriate next step?
, A) Magnesium sulfate and immediate delivery
(cesarean or induction)
B) Labetalol for blood pressure control and
outpatient follow-up
C) Expectant management until 37 weeks
D) IV hydralazine and discharge
Correct answer: A
Rationale: This patient has severe preeclampsia with
HELLP syndrome (thrombocytopenia, epigastric
pain). Delivery is indicated regardless of gestational
age after 34 weeks.
6. A 35-year-old G3P2 at 32 weeks gestation presents
with preterm premature rupture of membranes
(PPROM). She is afebrile with no uterine tenderness.
Ultrasound shows oligohydramnios. What is the most
appropriate next step?
A) Hospital admission, corticosteroids, and expectant
management
B) Immediate delivery (induction or cesarean)
C) Outpatient antibiotics
D) Amnioinfusion
Correct answer: A
