Obstetrics and Gynaecology Flashcards

A woman at 41 weeks gestation presents for routine assessment. Non-stress test shows a reactive pattern. What does this indicate?

Answer: Normal fetal well-being

A reactive non-stress test (NST) shows ≥2 accelerations of ≥15 bpm above baseline lasting ≥15 seconds within a 20-minute period, indicating normal fetal autonomic function and well-being. This is reassuring.

A 26-year-old woman presents with cyclical pelvic pain, dysmenorrhoea, dyspareunia, and infertility. Laparoscopy reveals chocolate cysts on the ovaries and powder-burn lesions on the peritoneum. What is the diagnosis?

Answer: Endometriosis

Endometriosis is characterised by the presence of endometrial tissue outside the uterus. Chocolate cysts (endometriomas) on the ovaries and powder-burn/gunshot lesions on the peritoneum are classic laparoscopic findings. It is a common cause of dysmenorrhoea and infertility.

A pregnant woman at 12 weeks gestation undergoes first-trimester screening. Nuchal translucency is 4.5 mm. What is the most appropriate next step?

Answer: Chorionic villus sampling (CVS) or cell-free fetal DNA testing

An increased nuchal translucency (≥3.5 mm) is associated with chromosomal abnormalities (particularly trisomy 21), cardiac defects, and other structural anomalies. The next step is either non-invasive prenatal testing (cfDNA) or invasive testing (CVS at this gestation) for definitive diagnosis.

A 60-year-old postmenopausal woman presents with vaginal bleeding. Endometrial thickness on ultrasound is 8 mm. What is the most appropriate next step?

Answer: Endometrial biopsy

Postmenopausal bleeding with endometrial thickness >4-5 mm on transvaginal ultrasound requires endometrial biopsy to exclude endometrial carcinoma, which is the most important diagnosis to rule out in this setting.

What is the Bishop score used for in obstetrics?

Answer: Evaluating cervical favourability for induction of labour

The Bishop score assesses cervical readiness for induction of labour based on five parameters: cervical dilation, effacement, station, consistency, and position. A score ≥8 indicates a favourable cervix with a high likelihood of successful induction.

A woman presents with a grape-like vesicular mass expelled from the vagina, a markedly elevated beta-hCG level, and a 'snowstorm' appearance on ultrasound. What is the most likely diagnosis?

Answer: Complete hydatidiform mole

A complete hydatidiform mole presents with vaginal bleeding, a uterus larger than dates, markedly elevated beta-hCG, and a classic 'snowstorm' or 'cluster of grapes' appearance on ultrasound. Suction evacuation followed by beta-hCG monitoring is the management.