PLAB Obstetrics & Gynecology Flashcards

Which finding on fetal cardiotocography (CTG) is most reassuring of fetal well-being?

Answer: Baseline fetal heart rate of 155 bpm with good variability and accelerations

A baseline fetal heart rate of 110–160 bpm with normal variability (6–25 bpm) and accelerations indicates a reactive, well-oxygenated fetus on CTG monitoring.

A 32-year-old woman at 34 weeks gestation presents with painless bright red vaginal bleeding. Ultrasound confirms placenta previa. What is the most appropriate immediate management?

Answer: IV access, blood type and crossmatch, IV fluids, and obstetric team review

Initial management of placenta previa with bleeding involves stabilizing the patient with IV access, blood typing and crossmatch, IV fluid resuscitation, and urgent obstetric team involvement; digital vaginal examination is contraindicated.

Which drug is used to prevent neural tube defects when taken periconceptionally?

Answer: Folic acid

Folic acid (400 mcg daily for women at standard risk, 5 mg for high-risk women) taken at least one month before conception and through the first trimester significantly reduces the risk of neural tube defects such as spina bifida.

A 30-year-old woman is found to have a cervical smear showing high-grade dyskaryosis (CIN II–III). What is the recommended management?

Answer: Colposcopy and biopsy

High-grade dyskaryosis (CIN II–III) on cervical smear requires urgent colposcopy with directed biopsy to confirm histology and guide treatment (e.g., LLETZ/LEEP excision).

What is the most common cause of postpartum hemorrhage (PPH)?

Answer: Uterine atony

Uterine atony (failure of the uterus to contract adequately after delivery) accounts for approximately 70–80% of postpartum hemorrhage cases, making it the most common cause.

A woman at 39 weeks presents with regular contractions. CTG shows prolonged deceleration to 80 bpm lasting 4 minutes that does not recover. What is the most appropriate action?

Answer: Emergency cesarean section

A prolonged deceleration lasting more than 3 minutes is a CTG emergency requiring immediate delivery, typically by emergency cesarean section (Category 1), as it indicates severe fetal compromise.