ABOG Obstetric Complications & Emergency Management 2

Question 1

According to ACOG criteria, which finding is required to diagnose preeclampsia in a patient WITHOUT proteinuria at 34 weeks gestation?

Accepted Answer

New-onset thrombocytopenia (platelets <100,000/μL)

Answer

Per ACOG 2013 guidelines, preeclampsia can be diagnosed without proteinuria if severe features are present, including thrombocytopenia (<100,000/μL), renal insufficiency, impaired liver function, pulmonary edema, or new-onset headache.

Question 2

A patient at 32 weeks is found to have hemolysis on peripheral smear, AST 320 U/L, and platelets of 78,000/μL. Which condition does this represent?

Accepted Answer

HELLP syndrome

Answer

HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of preeclampsia with this characteristic triad and requires prompt delivery planning.

Question 3

A patient at 36 weeks presents with painful, constant uterine contractions, vaginal bleeding, and a rigid board-like abdomen. Fetal heart tones show late decelerations. What is the most likely diagnosis?

Accepted Answer

Placental abruption

Answer

Placental abruption classically presents with painful vaginal bleeding, uterine rigidity/hypertonicity, and fetal distress due to retroplacental hemorrhage separating the placenta from the uterine wall.

Question 4

A patient on magnesium sulfate infusion develops loss of deep tendon reflexes and respiratory rate of 10 breaths/min. What is the correct immediate management?

Accepted Answer

Stop magnesium infusion and administer calcium gluconate IV

Answer

Magnesium toxicity manifests as loss of deep tendon reflexes followed by respiratory depression; treatment is immediate cessation of magnesium and IV calcium gluconate (1 g) as an antidote.

Question 5

Vasa previa is most definitively diagnosed by which modality, and what is the recommended delivery route?

Accepted Answer

Transvaginal ultrasound with color Doppler; planned cesarean at 34–36 weeks

Answer

Transvaginal ultrasound with color Doppler identifies fetal vessels traversing the membranes over the cervical os, and planned cesarean at 34–36 weeks avoids catastrophic hemorrhage at membrane rupture.

(ABOG) American Board of Obstetrics & Gynecology Practice Test

(ABOG) American Board of Obstetrics & Gynecology Practice Test

ABOG Obstetric Complications & Emergency Management 2