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Common Obstetrical Complications Flashcards

7 cards from real MCCQE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 24-year-old G1P0 at 12 weeks presents with severe nausea, vomiting, and weight loss of 5 kg. Her urine shows large ketones. Beta-hCG is markedly elevated and ultrasound shows a 'snowstorm' appearance without a fetal pole. What is the diagnosis?

    Answer: Complete hydatidiform mole

    A complete hydatidiform mole presents with markedly elevated hCG, hyperemesis, snowstorm ultrasound, and absence of fetal tissue.

  2. A 38-year-old G4P3 at 32 weeks presents with sudden onset severe abdominal pain and uterine rigidity. She denies bleeding. BP is 150/98. On CTG, late decelerations are noted. What is the most likely diagnosis?

    Answer: Placental abruption

    Placental abruption classically presents with painful uterine rigidity, may have concealed hemorrhage, and is associated with hypertension.

  3. A neonate born at 29 weeks develops respiratory distress, intercostal retractions, and nasal flaring within 2 hours of birth. CXR shows ground-glass opacification with air bronchograms. What is the pathophysiology?

    Answer: Surfactant deficiency causing alveolar collapse

    Respiratory distress syndrome (RDS) in premature neonates is caused by surfactant deficiency, leading to diffuse alveolar collapse and the characteristic ground-glass appearance.

  4. A 29-year-old woman at 20 weeks is found to have cervical length of 18 mm on transvaginal ultrasound during routine anatomy scan. She had a second-trimester loss last pregnancy. What is the most appropriate management?

    Answer: Cervical cerclage placement

    Women with prior second-trimester loss and short cervix benefit from cervical cerclage to reduce the risk of recurrent preterm birth.

  5. During a vacuum-assisted vaginal delivery, a pop is heard and the cup detaches. After reapplication, another pop occurs. What is the recommended course of action?

    Answer: Abandon vacuum and proceed to caesarean delivery

    Two cup detachments (pop-offs) are an indication to abandon vacuum delivery and proceed to caesarean to prevent fetal injury.

  6. A 33-year-old G2P1 at 37 weeks with known HIV on HAART has a viral load of 450 copies/mL at 36 weeks. What is the recommended mode of delivery?

    Answer: Elective caesarean section at 37-38 weeks to reduce vertical transmission

    Elective caesarean section is recommended for HIV-positive women with viral load >400 copies/mL at 36 weeks to reduce vertical transmission risk.

  7. A 31-year-old G1P0 at 28 weeks presents with preterm prelabour rupture of membranes (PPROM). Speculum exam confirms rupture. She has no signs of chorioamnionitis. What antibiotic regimen is most appropriate?

    Answer: Erythromycin and ampicillin for 48 hours then oral erythromycin for 5 days

    The standard regimen for PPROM without chorioamnionitis is IV ampicillin plus erythromycin for 48 hours followed by oral erythromycin for 5 days (avoiding amoxicillin-clavulanate due to NEC risk).