LATEST OB/GYN – MATERNAL-FETAL
MEDICINE CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 28-year-old G1P0 at 38 weeks gestation presents
with severe epigastric pain, nausea, and headache.
Blood pressure is 170/110 mm Hg. Urine protein is 3+
(300 mg/dL). Platelet count is 80,000/μL. AST is 120
U/L, ALT 150 U/L. What is the most appropriate next
step?
A) Magnesium sulfate and immediate delivery
(cesarean or induction)
B) Labetalol and outpatient follow-up
C) Expectant management until 39 weeks
D) IV hydralazine and discharge
Correct answer: A
Rationale: This patient has severe preeclampsia with
HELLP syndrome (thrombocytopenia, elevated liver
enzymes). Delivery is indicated regardless of
gestational age after 34 weeks.
,2. A 32-year-old G2P1 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
Rationale: PPROM at 32 weeks: admit, administer
corticosteroids for fetal lung maturity, antibiotics
(latency) with GBS prophylaxis, and monitor for
chorioamnionitis.
3. A 28-year-old G1P0 at 30 weeks gestation presents
with severe preeclampsia (BP 170/110 mm Hg). She
has stable vital signs and no neurologic symptoms.
What is the most appropriate next step?
A) Magnesium sulfate for seizure prophylaxis and
delivery
B) Labetalol and outpatient management
C) Expectant management until 34 weeks
,D) IV hydralazine and discharge
Correct answer: A
Rationale: Severe preeclampsia at ≥30 weeks: deliver
after stabilization (magnesium sulfate,
antihypertensives). Expectant management only for
<34 weeks with stable disease.
4. A 25-year-old G1P0 at 39 weeks gestation is in
active labor. The fetal heart rate tracing shows late
decelerations with minimal variability. What is the
most appropriate next step?
A) Intrauterine resuscitation (oxygen, reposition,
fluids, stop oxytocin) and consider delivery
B) Continue oxytocin
C) Immediate cesarean delivery
D) Scalp stimulation
Correct answer: A
Rationale: Late decelerations with minimal variability
suggest uteroplacental insufficiency. Intrauterine
resuscitation is first-line; expedite delivery if no
improvement.
5. A 32-year-old G2P1 at 36 weeks gestation with
placenta previa and a history of prior cesarean
, delivery presents with bleeding and contractions.
Ultrasound suggests placenta accreta. What is the
most appropriate next step?
A) Scheduled cesarean hysterectomy at 36-37 weeks
with multidisciplinary team
B) Conservative management with Bakri balloon
C) Methotrexate
D) Outpatient monitoring
Correct answer: A
Rationale: Suspected placenta accreta with previa
and prior cesarean requires planned cesarean
hysterectomy at 36-37 weeks with interventional
radiology and blood products.
6. A 28-year-old G1P0 at 38 weeks gestation with a
history of gestational diabetes (diet-controlled)
presents for induction. Fetal ultrasound estimates
fetal weight at 4,500 g. What is the most appropriate
next step?
A) Cesarean delivery (macrosomia with estimated
fetal weight >4,500 g in a non-diabetic patient)
B) Trial of labor
C) Induction of labor
D) Amniocentesis for fetal lung maturity
MEDICINE CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 28-year-old G1P0 at 38 weeks gestation presents
with severe epigastric pain, nausea, and headache.
Blood pressure is 170/110 mm Hg. Urine protein is 3+
(300 mg/dL). Platelet count is 80,000/μL. AST is 120
U/L, ALT 150 U/L. What is the most appropriate next
step?
A) Magnesium sulfate and immediate delivery
(cesarean or induction)
B) Labetalol and outpatient follow-up
C) Expectant management until 39 weeks
D) IV hydralazine and discharge
Correct answer: A
Rationale: This patient has severe preeclampsia with
HELLP syndrome (thrombocytopenia, elevated liver
enzymes). Delivery is indicated regardless of
gestational age after 34 weeks.
,2. A 32-year-old G2P1 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
Rationale: PPROM at 32 weeks: admit, administer
corticosteroids for fetal lung maturity, antibiotics
(latency) with GBS prophylaxis, and monitor for
chorioamnionitis.
3. A 28-year-old G1P0 at 30 weeks gestation presents
with severe preeclampsia (BP 170/110 mm Hg). She
has stable vital signs and no neurologic symptoms.
What is the most appropriate next step?
A) Magnesium sulfate for seizure prophylaxis and
delivery
B) Labetalol and outpatient management
C) Expectant management until 34 weeks
,D) IV hydralazine and discharge
Correct answer: A
Rationale: Severe preeclampsia at ≥30 weeks: deliver
after stabilization (magnesium sulfate,
antihypertensives). Expectant management only for
<34 weeks with stable disease.
4. A 25-year-old G1P0 at 39 weeks gestation is in
active labor. The fetal heart rate tracing shows late
decelerations with minimal variability. What is the
most appropriate next step?
A) Intrauterine resuscitation (oxygen, reposition,
fluids, stop oxytocin) and consider delivery
B) Continue oxytocin
C) Immediate cesarean delivery
D) Scalp stimulation
Correct answer: A
Rationale: Late decelerations with minimal variability
suggest uteroplacental insufficiency. Intrauterine
resuscitation is first-line; expedite delivery if no
improvement.
5. A 32-year-old G2P1 at 36 weeks gestation with
placenta previa and a history of prior cesarean
, delivery presents with bleeding and contractions.
Ultrasound suggests placenta accreta. What is the
most appropriate next step?
A) Scheduled cesarean hysterectomy at 36-37 weeks
with multidisciplinary team
B) Conservative management with Bakri balloon
C) Methotrexate
D) Outpatient monitoring
Correct answer: A
Rationale: Suspected placenta accreta with previa
and prior cesarean requires planned cesarean
hysterectomy at 36-37 weeks with interventional
radiology and blood products.
6. A 28-year-old G1P0 at 38 weeks gestation with a
history of gestational diabetes (diet-controlled)
presents for induction. Fetal ultrasound estimates
fetal weight at 4,500 g. What is the most appropriate
next step?
A) Cesarean delivery (macrosomia with estimated
fetal weight >4,500 g in a non-diabetic patient)
B) Trial of labor
C) Induction of labor
D) Amniocentesis for fetal lung maturity
