Maternal and Child Health Practice Questions

Q: How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6 months of age after an episode of acute diarrhoea?

10 mg per day for 10–14 days. **10 mg per day for 10–14 days** - For infants less than 6 months of age, **WHO and UNICEF** recommend **10 mg of elemental zinc per day** for 10-14 days following an acute diarrheal episode. - This dosage helps to reduce the severity and duration of the current diarrheal episode and prevents future episodes for several months. *20 mg per day for 10–14 days* - This dosage is recommended for **children 6 months of age and older**, not for infants under 6 months. - Providing 20 mg elemental zinc to infants under 6 months could lead to **zinc toxicity** or other adverse effects. *6 mg per day for 7 days* - This recommendation is below the **standard therapeutic dose** for infants, which may not be sufficient to achieve the desired clinical benefit. - The duration of **7 days** is also shorter than the generally recommended 10-14 days. *5 mg per day for 7 days* - Similar to 6 mg, this dose is **insufficient** for effective treatment of acute diarrhea in infants. - The shortened duration of 7 days further reduces its potential therapeutic impact, increasing the risk of **recurrence or prolonged symptoms**.

Q: The net effect of antenatal care has been the following EXCEPT:

Reduction in the incidence of institutional delivery. ***Reduction in the incidence of institutional delivery*** - Antenatal care aims to increase awareness of safe delivery practices and encourage women to deliver in health facilities, thereby **increasing institutional deliveries**, not reducing them. - Improved access to and understanding of obstetric care through ANC promotes safer childbirth environments. *Reduction in maternal morbidity* - Antenatal care plays a crucial role in the early detection and management of **pregnancy-related complications** such as pre-eclampsia, gestational diabetes, and infections. - This proactive management minimizes the severity and impact of these conditions on maternal health. *Reduction in perinatal mortality* - Regular antenatal visits allow for monitoring of fetal growth and well-being, identification of **fetal distress**, and intervention for conditions like intrauterine growth restriction. - Early detection and management of issues affecting the fetus significantly improve perinatal outcomes and reduce **stillbirths** and **neonatal deaths**. *Reduction in maternal mortality* - ANC provides essential health education, nutritional advice, and timely vaccinations, which are vital for a healthy pregnancy. - It also facilitates preparedness for childbirth and potential complications, thereby **reducing the risk of maternal death** from preventable causes.

Q: Which one of the following is the most commonly used surgical method/technique of female sterilization as recommended by Government of India?

Pomeroy's method. ***Pomeroy's method*** - **Pomeroy's method** involves creating a loop of the fallopian tube, ligating its base, and excising the looped segment, which is a highly effective and widely used surgical sterilization technique. - This method is the **most commonly recommended by the Government of India** for female sterilization under the national family planning program, typically performed via minilaparotomy (minilap) approach. - It is preferred due to its **simplicity, high efficacy, and low complication rates**, making it particularly suitable for resource-constrained settings and large-scale implementation in India. *Madlener technique* - The **Madlener technique** involves crushing and ligating a loop of the fallopian tube without excising any segment, making it less robust and potentially leading to higher recanalization rates. - This method is generally considered less effective compared to techniques that involve segment excision or destruction, hence it is not the most commonly recommended. *Uchida technique* - The **Uchida technique** involves injecting a sclerosing solution into the fallopian tube and then excising a portion of the tube, aiming to induce extensive fibrosis and prevent recanalization. - While effective, it is a more complex procedure than Pomeroy's method, requiring specialized training and materials, making it less suitable for widespread adoption as a primary method in national programs. *Irving method* - The **Irving method** involves ligating and transecting the fallopian tube, then burying the proximal stump into the broad ligament and the distal stump under the serosa, creating multiple barriers to recanalization. - This technique is highly effective but is considered more technically demanding and time-consuming than Pomeroy's method, which limits its widespread use as the go-to sterilization method in public health programs.

Q: Pearl index for contraceptive effectiveness is calculated in terms of which of the following? 1. Pregnancy rate 2. Abortion rate 3. Hundred woman years 4. Thousand woman years Select the correct answer using the code given below:

1 and 3. ***1 and 3*** - The **Pearl Index** is a common method for measuring the **effectiveness of contraception**. - It calculates the number of pregnancies per **100 women-years** of exposure to a particular contraceptive method. *2 and 3* - While abortions can occur in cases of contraceptive failure, the **Pearl Index** specifically focuses on the **pregnancy rate**, not the abortion rate. - The denominator of **hundred woman-years** is correct, but abortion rate is not a direct component of the Pearl Index calculation. *1 only* - The **pregnancy rate** is indeed a key component of the Pearl Index, but it must be expressed in a standardized unit, which is typically **hundred woman-years**. - Simply stating "pregnancy rate" without the context of exposure time is insufficient for the Pearl Index. *1, 2 and 4* - The **Pearl Index** does not directly incorporate the **abortion rate**. - Its standard denomination is **hundred woman-years**, not thousand woman-years.

Q: Which contraceptive method is most effective in preventing sexually transmitted infections?

Male condoms. ***Male condoms*** - **Male condoms** are the most effective method available for preventing the transmission of **STIs**, including HIV, gonorrhea, chlamydia, and syphilis, when used correctly and consistently. - They act as a **physical barrier** that prevents the exchange of bodily fluids and skin-to-skin contact where infections might be present. *Spermicides* - **Spermicides** are chemical substances designed to kill sperm and prevent pregnancy, but they offer **no protection against STIs**. - In fact, some spermicides, especially those containing **nonoxynol-9**, can irritate genital tissues and may even increase the risk of STI transmission by causing micro-abrasions. *Hormonal contraceptives* - **Hormonal contraceptives** (e.g., birth control pills, patches, injections, vaginal rings) are highly effective at preventing pregnancy by inhibiting ovulation. - However, they offer **no protection against STIs** because they do not create a physical barrier to prevent the exchange of infectious bodily fluids or skin contact. *Intrauterine devices* - **Intrauterine devices (IUDs)** are T-shaped devices inserted into the uterus for long-term pregnancy prevention. They are highly effective for contraception. - Similar to hormonal contraceptives, IUDs provide **no protection against STIs**, as they do not block the transmission pathways for infections.

Q: The number of maternal deaths per 100,000 live births is called-

Maternal mortality ratio. ***Maternal mortality ratio*** - This is the standard epidemiological indicator defining the number of **maternal deaths per 100,000 live births**. - It measures the risk of death due to pregnancy in a population. *Maternal mortality rate* - This term is often used interchangeably with maternal mortality ratio, but technically, a **rate usually includes time in the denominator** (e.g., deaths per person-year). - While related to maternal mortality, it's not the precise term for deaths per live births. *Infant mortality rate* - This measures the number of **deaths of infants under one year of age per 1,000 live births**. - It does not specifically refer to deaths of mothers. *Perinatal mortality rate* - This calculates the number of **stillbirths and deaths in the first week of life per 1,000 total births** (live births plus stillbirths). - It focuses on deaths around the time of birth in the infant, not the mother.

Q: Calculate the maternal mortality ratio (MMR) for the year 2023, given the following data: - Total live births: 4,000 - Women who died: 6 (1 due to a road traffic accident (RTA), 1 due to sepsis, 1 due to obstructed labor, 1 due to eclampsia, 1 due to ectopic pregnancy, and 1 due to a snake bite)

100 per 100,000 live births. ***Correct: 100 per 100,000 live births*** - The **maternal mortality ratio (MMR)** includes deaths directly or indirectly due to pregnancy, childbirth, or within 42 days of termination of pregnancy, **excluding accidental or incidental causes**. - In this scenario, **4 maternal deaths** are identified: sepsis (direct), obstructed labor (direct), eclampsia (direct), and ectopic pregnancy (direct). - **Excluded deaths**: RTA and snake bite are **incidental/accidental deaths** not related to pregnancy complications. - **Calculation**: MMR = (4 / 4,000) × 100,000 = **100 per 100,000 live births** *Incorrect: 75 per 100,000 live births* - This would incorrectly count only **3 maternal deaths** instead of 4, suggesting underestimation or exclusion of a valid maternal death (e.g., ectopic pregnancy). - Represents a **miscalculation** that underestimates maternal mortality burden. *Incorrect: 150 per 100,000 live births* - This would incorrectly include **6 deaths** (all deaths including RTA and snake bite), failing to exclude incidental causes. - Including **non-maternal accidental deaths** inflates MMR and misrepresents actual maternal health outcomes. *Incorrect: 125 per 100,000 live births* - This would incorrectly count **5 deaths**, suggesting inclusion of one incidental death (either RTA or snake bite). - Fails to properly identify and exclude **both incidental deaths**, leading to an overestimated ratio.

Q: Given the following data: 500 live births and 9 deaths within the first 7 days, calculate the early neonatal mortality rate.

18 per 1,000 live births. ***18 per 1,000 live births*** - The **early neonatal mortality rate** is calculated as (number of deaths within the first 7 days / total live births) × 1,000. - In this case, (9 deaths / 500 live births) × 1,000 = **18 per 1,000 live births**. *36 per 1,000 live births* - This value would be obtained by incorrectly doubling the correct calculation. - This represents a common calculation error where the result is multiplied by 2 instead of the standard multiplier of 1,000. *24 per 1,000 live births* - This value would be obtained if there were 12 deaths within the first 7 days, which is not the case here. - This option does not reflect the given data of 9 deaths within 500 live births. *50 per 1,000 live births* - This value would be obtained if there were 25 deaths within the first 7 days. - This option significantly overestimates the early neonatal mortality based on the provided data.

Q: The formula with the numerator as maternal deaths and the denominator as women of reproductive age is used to calculate which of the following?

Maternal mortality rate. ***Maternal mortality rate*** - This formula calculates the **maternal mortality rate**, which expresses the risk of dying from pregnancy-related causes among women of reproductive age in a population. - It uses the total number of maternal deaths in the numerator and the total number of **women of reproductive age** (usually 15-49 years) in the denominator, typically multiplied by a constant (e.g., 100,000) to get a per population figure. *Maternal mortality ratio* - The **maternal mortality ratio** uses the number of **live births** (or live births plus stillbirths) in the denominator, not women of reproductive age. - It measures the risk of maternal death per 100,000 live births, reflecting the obstetric risk associated with each pregnancy. *Perinatal mortality rate* - The **perinatal mortality rate** relates to deaths of fetuses and newborns (typically from 22 weeks gestation up to 7 days after birth), not maternal deaths. - Its numerator includes **fetal deaths** and **early neonatal deaths**, and the denominator is usually total births (live births + stillbirths). *Perinatal mortality ratio* - This term is less commonly used as a distinct epidemiological measure; typically, the term **perinatal mortality rate** encompasses both the frequency of perinatal deaths relative to total births. - It does not involve maternal deaths or women of reproductive age in its calculation.

Q: What does JSSK stand for?

Janani Shishu Suraksha Karyakram. ***Janani Shishu Suraksha Karyakram*** - **JSSK** is a program initiated by the Indian government to provide **free healthcare services** to pregnant women and sick neonates. - The acronym stands for **Janani Shishu Suraksha Karyakram**, emphasizing "Karyakram" which means program. *Janani Shishu Swasthya Karyakram* - While "Swasthya" means **health**, it is not the correct word in the official acronym for this government initiative. - The official program focuses on "Suraksha" or **safety/protection** for mother and child during childbirth and infancy. *Janani Shishu Suraksha Kendra* - "Kendra" means **center** and indicates a facility, but the program itself is broader than just a center. - The initiative is a comprehensive "Karyakram" or **program** of services, not merely a physical location. *Janani Shishu Swasthya Kendra* - This option incorrectly combines "Swasthya" (health) and "Kendra" (center), neither of which accurately reflect the full acronym. - The correct acronym uses "Suraksha" (safety/protection) and "Karyakram" (program).

Question 1

How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6 months of age after an episode of acute diarrhoea?

Accepted Answer

10 mg per day for 10–14 days

Answer

20 mg per day for 10–14 days

Answer

6 mg per day for 7 days

Answer

5 mg per day for 7 days

Question 2

The net effect of antenatal care has been the following EXCEPT:

Accepted Answer

Reduction in the incidence of institutional delivery

Answer

Reduction in maternal morbidity

Answer

Reduction in perinatal mortality

Answer

Reduction in maternal mortality

Question 3

Which one of the following is the most commonly used surgical method/technique of female sterilization as recommended by Government of India?

Accepted Answer

Pomeroy's method

Answer

Madlener technique

Answer

Uchida technique

Answer

Irving method

Question 4

Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

Accepted Answer

1 and 3

Answer

2 and 3

Answer

1 only

Answer

1, 2 and 4

Question 5

Which contraceptive method is most effective in preventing sexually transmitted infections?

Accepted Answer

Male condoms

Answer

Spermicides

Answer

Hormonal contraceptives

Answer

Intrauterine devices

Question 6

The number of maternal deaths per 100,000 live births is called-

Accepted Answer

Maternal mortality ratio

Answer

Maternal mortality rate

Answer

Infant mortality rate

Answer

Perinatal mortality rate

Question 7

Calculate the maternal mortality ratio (MMR) for the year 2023, given the following data:

- Total live births: 4,000
- Women who died: 6 (1 due to a road traffic accident (RTA), 1 due to sepsis, 1 due to obstructed labor, 1 due to eclampsia, 1 due to ectopic pregnancy, and 1 due to a snake bite)

Accepted Answer

100 per 100,000 live births

Answer

75 per 100,000 live births

Answer

150 per 100,000 live births

Answer

125 per 100,000 live births

Question 8

Given the following data: 500 live births and 9 deaths within the first 7 days, calculate the early neonatal mortality rate.

Accepted Answer

18 per 1,000 live births

Answer

36 per 1,000 live births

Answer

24 per 1,000 live births

Answer

50 per 1,000 live births

Question 9

The formula with the numerator as maternal deaths and the denominator as women of reproductive age is used to calculate which of the following?

Accepted Answer

Maternal mortality rate

Answer

Maternal mortality ratio

Answer

Perinatal mortality rate

Answer

Perinatal mortality ratio

Question 10

What does JSSK stand for?

Accepted Answer

Janani Shishu Suraksha Karyakram

Answer

Janani Shishu Swasthya Karyakram

Answer

Janani Shishu Suraksha Kendra

Answer

Janani Shishu Swasthya Kendra

Maternal and Child Health — MCQs

Maternal and Child Health — MCQs

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