UPSC-CMS 2024 - Obstetrics and Gynecology PYQs Practice Questions

Q: Consider the following statements regarding oligohydramnios: 1. It is defined on USG when maximum vertical pocket of liquor is less than 3 cm. 2. It is defined on USG when AFI is less than 5 cm. 3. It is associated with increased risk of cord compression during labor. 4. It is commonly seen in post-term pregnancies. Select the correct answer using the code given below.

2, 3 and 4. ***2, 3 and 4*** - This option correctly identifies the accurate definitions and associations of **oligohydramnios**. - Statement 2 correctly defines oligohydramnios as **AFI 42 weeks) due to placental insufficiency and reduced fetal urine production. *1 and 2 only* - Statement 1 is **incorrect**: oligohydramnios is defined as maximum vertical pocket (MVP) **< 2 cm**, not < 3 cm. - This option excludes the important clinical associations of cord compression and post-term pregnancy. *1, 2 and 4* - Statement 1 is **incorrect**: the correct cutoff for MVP is **< 2 cm**, not < 3 cm. - This option misses the crucial risk of **cord compression** during labor. *1, 3 and 4* - Statement 1 is **incorrect**: oligohydramnios by MVP method is defined as **< 2 cm**, not < 3 cm. - This option misses the alternative and commonly used definition via **AFI < 5 cm**. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following are correct about endocrine changes in normal pregnancy? 1. Increase in levels of maternal serum iodine 2. Increase in serum levels of Corticotropin-Releasing Hormone (CRH) 3. Increase in serum levels of aldosterone Select the answer using the code given below.

2 and 3 only. ***2 and 3 only*** - **Corticotropin-releasing hormone (CRH)** levels increase dramatically during pregnancy, produced by the **placenta**, influencing the timing of labor and fetal development. - **Aldosterone** levels significantly increase during pregnancy to help maintain **fluid balance** and counteract the natriuretic effects of increased progesterone and vasodilation. *1 and 2 only* - While CRH levels do increase, **maternal serum iodine levels do not increase**; rather, there is an increased demand for iodine and a decrease in serum iodine concentration due to increased renal clearance and transfer to the fetus. - This option incorrectly states an increase in maternal serum iodine. *1 and 3 only* - Although aldosterone levels increase, **maternal serum iodine levels do not increase** during normal pregnancy. - This option incorrectly implies an increase in serum iodine while correctly identifying an increase in aldosterone. *1, 2 and 3* - This option is incorrect because **maternal serum iodine levels do not increase** in normal pregnancy; instead, there is often a relative iodine deficiency due to increased demand and excretion. - Only CRH and aldosterone levels increase among the choices provided. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: Which of the following features are correct regarding onset of true labour? 1. Regular uterine contractions 2. Progressive cervical dilation and effacement 3. Presence of show 4. Labour and delivery are synonymous Select the answer using the code given below.

1, 2 and 3. ***Correct: 1, 2 and 3*** - **Regular uterine contractions** (statement 1) are a hallmark of true labor, occurring at regular intervals with increasing frequency, duration, and intensity. - **Progressive cervical dilation and effacement** (statement 2) is the definitive diagnostic criterion for true labor, distinguishing it from false labor (Braxton Hicks contractions). - **Presence of 'show'** (statement 3) - the expulsion of the cervical mucus plug mixed with blood - is a common and reliable indicator of true labor onset. - Statement 4 is **incorrect**: labor and delivery are **not synonymous**. **Labor** is the entire process of childbirth (contractions, cervical changes, descent of fetus), while **delivery** refers specifically to the expulsion of the baby. *Incorrect: 2, 3 and 4* - Incorrectly includes statement 4, which falsely claims labor and delivery are synonymous. - Omits statement 1 (regular uterine contractions), which is a fundamental feature of true labor. *Incorrect: 1, 3 and 4* - Incorrectly includes statement 4 about labor and delivery being synonymous. - Critically omits statement 2 (progressive cervical dilation and effacement), which is the most important diagnostic criterion for true labor. *Incorrect: 1, 2 and 4* - Incorrectly includes statement 4, which is false. - Omits statement 3 (presence of show), which is a valid indicator of true labor onset. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: According to the WHO Intrapartum Care Guidelines, 2018, the active phase of labour starts from what dilation of cervix?

5 cm. ***5 cm*** - According to the **WHO Intrapartum Care Guidelines, 2018**, the active first stage of labor is defined as starting when the cervix is dilated to **5 cm**. - The WHO guidelines state: "The active first stage is the period of time from 5 cm of cervical dilatation until full cervical dilatation." - This updated definition aims to reduce unnecessary interventions, as cervical dilation before 5 cm (latent phase) can be slow and variable, which is part of normal labor progression. *6 cm* - **6 cm cervical dilation** is beyond the threshold defined by WHO 2018 guidelines for the start of active phase. - While some clinicians may use 6 cm as a benchmark in practice, the **official WHO 2018 guideline** specifically designates **5 cm** as the starting point. *4 cm* - Historically, **4 cm cervical dilation** was considered the start of the active phase in older definitions (Friedman curve). - This earlier benchmark led to premature diagnosis of "failure to progress" and increased interventions. - The **WHO 2018 guidelines** revised this upward to **5 cm** to reflect a more expectant management approach for slow but normal labor progression. *3 cm* - A **cervical dilation of 3 cm** is typically within the latent phase of labor, where cervical changes are usually slower and less predictable. - Defining the active phase at this early stage would significantly increase the possibility of diagnosing **abnormal labor patterns** prematurely and lead to unnecessary interventions. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Q: The diameter of engagement of foetal skull in marked deflexion is

occipitofrontal diameter. ***occipitofrontal diameter*** - In cases of **marked deflexion** (also called **persistent occipitoposterior** or **military attitude** in some contexts), the fetal head presents with extension, causing the **occipitofrontal diameter** to engage. - This diameter extends from the **occipital protuberance to the root of the nose (glabella)**, measuring approximately **11.5 cm**. - This represents a **moderately extended** attitude of the fetal head, making vaginal delivery more challenging than with flexion. *suboccipitofrontal diameter* - This diameter measures about **10.0 cm** and engages with **partial deflexion**. - It extends from the **subocciput to the glabella** (center of forehead). - This is an intermediate position between full flexion and marked deflexion. *suboccipitobregmatic diameter* - This is the diameter of engagement in a **well-flexed head** (normal vertex presentation), measuring approximately **9.5 cm**. - It extends from the **subocciput to the bregma** (anterior fontanelle). - This is the **ideal diameter** for vaginal birth as it presents the smallest diameter. *mentovertical diameter* - This diameter is relevant in **brow presentation** (maximum deflexion/extension), measuring about **13-13.5 cm**. - It extends from the **chin (mentum) to the vertex**. - Brow presentation is **highly unfavorable** for vaginal delivery due to this very large engaging diameter and typically requires cesarean section. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Consider the following statements regarding oligohydramnios:

1. It is defined on USG when maximum vertical pocket of liquor is less than 3 cm.

2. It is defined on USG when AFI is less than 5 cm.

3. It is associated with increased risk of cord compression during labor.

4. It is commonly seen in post-term pregnancies.

Select the correct answer using the code given below.

Accepted Answer

2, 3 and 4

Answer

1 and 2 only

Answer

1, 2 and 4

Answer

1, 3 and 4

Question 2

Which of the following are correct about endocrine changes in normal pregnancy?

1. Increase in levels of maternal serum iodine
2. Increase in serum levels of Corticotropin-Releasing Hormone (CRH)
3. Increase in serum levels of aldosterone Select the answer using the code given below.

Accepted Answer

2 and 3 only

Answer

1 and 2 only

Answer

1 and 3 only

Answer

1, 2 and 3

Question 3

Which of the following features are correct regarding onset of true labour?

1. Regular uterine contractions
2. Progressive cervical dilation and effacement
3. Presence of show
4. Labour and delivery are synonymous Select the answer using the code given below.

Accepted Answer

1, 2 and 3

Answer

2, 3 and 4

Answer

1, 3 and 4

Answer

1, 2 and 4

Question 4

According to the WHO Intrapartum Care Guidelines, 2018, the active phase of labour starts from what dilation of cervix?

Accepted Answer

5 cm

Answer

4 cm

Answer

3 cm

Answer

6 cm

Question 5

The diameter of engagement of foetal skull in marked deflexion is

Accepted Answer

occipitofrontal diameter

Answer

suboccipitofrontal diameter

Answer

suboccipitobregmatic diameter

Answer

mentovertebral diameter

Question 6

Which of the following are correct regarding pathological findings of placenta accreta?

1. Absence of decidua basalis
2. Absence of Nitabuch's fibrinoid layer
3. Loss of normal hypoechoic retroplacental myometrial zone in ultrasonography Select the answer using the code given below.

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 7

Which of the following statements are correct regarding peripartum cardiomyopathy?

1. It is usually seen in multiparous women.
2. Echocardiography shows ejection fraction less than 45%.
3. ACE inhibitors are contraindicated.
4. History of prior heart disease is mostly present. Select the answer using the code given below.

Accepted Answer

1 and 2 only

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

3 and 4 only

Question 8

A 28-year-old female G2P1L1 with history of previous cesarean presents to the gynaecology emergency in labour. On examination, she is hypotensive, foetal heart sounds are absent and foetal parts are easily palpable. What is her diagnosis?

Accepted Answer

Uterine rupture

Answer

Hydatidiform mole

Answer

Oligohydramnios

Answer

Abruptio placentae

Question 9

A 24-year-old primigravida comes to ANC clinic at 8 months amenorrhoea. Her BP is found to be 160/100 mm Hg. Lab findings reveal thrombocytopenia, increased SGOT/SGPT and LDH. What is her diagnosis?

Accepted Answer

HELLP syndrome

Answer

Eclampsia

Answer

Hepatitis B

Answer

Obstetric cholestasis

Question 10

A patient, who is 2 months pregnant, reports to a hospital with complaints of increased vaginal bleeding and pain in lower abdomen. Internal examination reveals dilated internal os of cervix and products of conception are felt through it. What is her likely clinical diagnosis?

Accepted Answer

Inevitable abortion

Answer

Threatened abortion

Answer

Incomplete abortion

Answer

Septic abortion

UPSC-CMS 2024 — Obstetrics and Gynecology