ABOG Obstetric Complications & Emergency Management 3

Question 1

A patient at 37 weeks has BP readings of 145/94 and 148/96 on two occasions 4 hours apart with no proteinuria and no severe features. What is the correct classification?

Accepted Answer

Gestational hypertension

Answer

Gestational hypertension is defined as new-onset BP ≥140/90 mmHg after 20 weeks without proteinuria or end-organ damage; when severe features or proteinuria are present, it becomes preeclampsia.

Question 2

A pregnant patient at 28 weeks has a BP of 162/108 requiring treatment. Which antihypertensive is contraindicated in pregnancy?

Accepted Answer

Lisinopril

Answer

ACE inhibitors (e.g., lisinopril) are absolutely contraindicated in pregnancy due to fetotoxicity including renal tubular dysgenesis, oligohydramnios, and fetal/neonatal renal failure.

Question 3

A biophysical profile (BPP) is performed at 34 weeks with the following findings: fetal breathing present, tone present, gross body movement present, amniotic fluid index 4 cm, but non-stress test non-reactive. What is the BPP score and recommended action?

Accepted Answer

Score 8/10; repeat in 24 hours or deliver if ≥37 weeks

Answer

With 4 positive components and a non-reactive NST (0 points), BPP = 8/10; this score is generally reassuring but oligohydramnios should prompt delivery consideration at ≥37 weeks or repeat testing.

Question 4

A Category III fetal heart rate tracing shows sinusoidal pattern at 39 weeks. What is the most appropriate immediate management?

Accepted Answer

Expedite delivery by the most rapid means available

Answer

A Category III tracing (sinusoidal pattern or absent variability with recurrent late/variable decelerations or bradycardia) mandates immediate evaluation and expeditious delivery as it predicts fetal acidemia.

Question 5

During active labor at 41 weeks, repetitive variable decelerations to 80 bpm lasting 60 seconds are noted. Cervix is 5 cm dilated. What is the FIRST intrauterine resuscitation step?

Accepted Answer

Maternal position change and discontinue oxytocin

Answer

Initial intrauterine resuscitation for variable decelerations includes position change (relieve cord compression), discontinuing oxytocin, and IV fluid bolus before escalating to invasive interventions.

(ABOG) American Board of Obstetrics & Gynecology Practice Test

(ABOG) American Board of Obstetrics & Gynecology Practice Test

ABOG Obstetric Complications & Emergency Management 3