UPSC-CMS 2022 — Obstetrics and Gynecology

32 Questions — Page 4 of 4

All Subjects Anatomy (2)Biochemistry (3)Community Medicine (27)Dermatology (2)ENT (1)Internal Medicine (21)Obstetrics and Gynecology (32)Pathology (6)Pediatrics (3)Pharmacology (6)Physiology (2)Radiology (1)Surgery (14)

Q31

Determination of alpha-fetoprotein levels in maternal serum is a useful screening tool for

Q32

As per the definition of the World Health Organization, 'late maternal death' is defined as the death of a woman from direct or indirect obstetric causes, after more than X days but less than one year after termination of pregnancy. Which one among the following is the correct value of X?

UPSC-CMS 2022 - Obstetrics and Gynecology UPSC-CMS Practice Questions and MCQs

Question 31: Determination of alpha-fetoprotein levels in maternal serum is a useful screening tool for

A. Duchenne muscular dystrophy
B. phenylketonuria
C. congenital hypothyroidism
D. neural tube defects (Correct Answer)

Explanation: ***Correct: neural tube defects*** - Elevated maternal serum **alpha-fetoprotein (AFP)** is a key indicator for open **neural tube defects** because the fetal tissue leaks AFP into the amniotic fluid and then into the maternal circulation. - This screening tool is sensitive enough to detect conditions like **spina bifida** and **anencephaly**. - Typically performed at **15-20 weeks gestation** as part of the triple or quad screen. *Incorrect: Duchenne muscular dystrophy* - This is a **genetically inherited X-linked recessive disorder** primarily diagnosed through genetic testing or muscle biopsy, not maternal serum AFP levels. - While **creatine kinase (CK)** levels can be elevated in affected individuals, it is not a prenatal AFP screening target. *Incorrect: phenylketonuria* - **Phenylketonuria (PKU)** is an inborn error of metabolism, typically screened for postnatally using a **newborn heel prick test** to detect elevated phenylalanine levels. - Maternal serum AFP is not used for its detection; the condition is managed by a special diet. *Incorrect: congenital hypothyroidism* - **Congenital hypothyroidism** is identified through **newborn screening programs** that measure levels of **thyroid-stimulating hormone (TSH)** or **thyroxine (T4)** from a heel prick. - Maternal serum AFP has no role in the screening or diagnosis of this condition.

Question 32: As per the definition of the World Health Organization, 'late maternal death' is defined as the death of a woman from direct or indirect obstetric causes, after more than X days but less than one year after termination of pregnancy. Which one among the following is the correct value of X?

A. 21
B. 7
C. 84
D. 42 (Correct Answer)

Explanation: ***Correct: 42*** - According to the **World Health Organization (WHO)**, **late maternal death** is defined as the death of a woman from direct or indirect obstetric causes occurring **more than 42 days** but less than one year after termination of pregnancy. - This definition helps in categorizing and understanding the timeframe and causes of maternal mortality beyond the immediate postpartum period. - The **42-day threshold** distinguishes between direct maternal deaths (within 42 days) and late maternal deaths (42 days to 1 year). *Incorrect: 21* - This value is not used in the WHO definition for the onset of late maternal death. - The **42-day mark** is the internationally recognized threshold for distinguishing between the immediate postpartum period and late maternal complications. *Incorrect: 7* - Seven days is too short a period for a death to be classified as **"late maternal death"**; deaths within this timeframe fall under **direct maternal deaths** in the immediate postpartum period. - This period is often associated with immediate postpartum complications such as **postpartum hemorrhage**, **eclampsia**, or **early-onset puerperal sepsis**. *Incorrect: 84* - While 84 days (12 weeks) is a significant period in postpartum recovery for some physiological changes, it is not the specific threshold used by the **WHO** to define the beginning of **late maternal death**. - The international standard remains **42 days** (6 weeks) as the transition point between direct and late maternal deaths.