Maternal-Fetal Medicine Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Maternal-Fetal Medicine. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Maternal-Fetal Medicine Indian Medical PG Question 1: Disputed maternity can be solved by using the following tests, EXCEPT:
- A. Blood grouping
- B. HLA typing
- C. DNA fingerprinting
- D. Precipitin test (Correct Answer)
Maternal-Fetal Medicine Explanation: ***Precipitin test***
- The **precipitin test** is used to determine the origin of a **blood sample**, specifically whether it is **human or animal blood**, by detecting species-specific proteins. It is not used for assessing maternity.
- This test is primarily employed in **forensic serology** to differentiate between blood from different animal species, making it irrelevant for paternity or maternity disputes.
*Blood grouping*
- **Blood grouping** (e.g., ABO and Rh systems) can be used to **exclude paternity or maternity** by comparing the blood types of the child, mother, and alleged father.
- If the child's blood type is incompatible with the alleged parents based on Mendelian inheritance, one or both can be excluded.
*HLA typing*
- **HLA typing** (Human Leukocyte Antigen) is a more powerful genetic marker system than ABO/Rh for determining paternity or maternity.
- It involves analyzing highly polymorphic genes on chromosome 6 that encode cell surface proteins, providing a more definitive means of **inclusion or exclusion**.
*DNA fingerprinting*
- **DNA fingerprinting** (also known as **DNA profiling**) is the **most accurate and widely accepted method** for resolving paternity and maternity disputes.
- It analyzes highly variable regions of DNA unique to each individual, providing a statistically strong basis for **inclusion or exclusion** by comparing genetic profiles.
Maternal-Fetal Medicine Indian Medical PG Question 2: As per the Sustainable Development Goals, what is the target for Maternal Mortality Ratio (MMR)?
- A. < 70 per 100,000 live births (Correct Answer)
- B. < 100 per 100,000 live births
- C. < 7 per 1,000 live births
- D. < 10 per 1,000 live births
Maternal-Fetal Medicine Explanation: ***< 70 per 100,000 live births***
- **Sustainable Development Goal (SDG) 3.1** specifically targets reducing the global maternal mortality ratio to less than **70 per 100,000 live births** by 2030.
- This target aims to address the significant disparities in maternal mortality rates observed across different regions and countries.
*< 100 per 100,000 live births*
- While this represents an improvement over current global averages, it is **not the specific target set by SDG 3.1** for maternal mortality.
- The SDGs establish a more ambitious threshold to ensure greater progress in maternal health outcomes.
*< 7 per 1,000 live births*
- This value is equivalent to **700 per 100,000 live births**, which is significantly higher than the SDG target and represents a **much higher maternal mortality rate**.
- This option reflects a misunderstanding of the scale and denominator used for maternal mortality ratios in the SDGs.
*< 10 per 1,000 live births*
- This value is equivalent to **1,000 per 100,000 live births**, which is also **significantly higher than the SDG target**.
- This option shows a similar misconception regarding the magnitude and proper reporting of maternal mortality ratios.
Maternal-Fetal Medicine Indian Medical PG Question 3: The maternal and child health care indicator that best reflects the extent of pregnancy wastage as well as the quantity and quality of health care available to the mother and newborn is:
- A. Infant Mortality Rate
- B. Perinatal Mortality Rate (Correct Answer)
- C. Maternal Mortality Rate
- D. Stillbirth Rate
Maternal-Fetal Medicine Explanation: ***Perinatal Mortality Rate***
- This rate includes both **stillbirths** (fetal deaths after 28 weeks of gestation) and **early neonatal deaths** (deaths within the first seven days of life), encompassing late pregnancy and the immediate post-delivery period.
- It reflects the quality of **antenatal care**, **obstetric care**, and **neonatal care**, thus indicating both pregnancy wastage and healthcare quality for mother and newborn.
*Infant Mortality Rate*
- The **Infant Mortality Rate** measures deaths of children under one year of age, which includes perinatal deaths but also covers a much broader period influenced by factors beyond immediate pregnancy and birth care.
- While an important indicator of child health, it is less specific for evaluating issues directly related to **pregnancy wastage** and **delivery care**.
*Maternal Mortality Rate*
- This rate focuses solely on deaths of women during pregnancy or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management.
- It directly reflects the safety of **maternity care** for the mother but does not include outcomes for the newborn or broader pregnancy wastage like stillbirths.
*Stillbirth Rate*
- The **Stillbirth Rate** specifically measures fetal deaths after 28 weeks (or 20 weeks in some definitions), providing an indicator of deaths in late pregnancy.
- While it reflects a significant portion of pregnancy wastage, it does not account for **neonatal deaths** or the quality of care for the live-born infant.
Maternal-Fetal Medicine Indian Medical PG Question 4: Cardiac diseases in pregnancy which have major risk of maternal mortality are:
1. Pulmonary hypertension
2. Aortic coarctation with valvular involvement
3. Atrial septal defect
4. Mitral stenosis
Select the correct answer using the code given below:
- A. 1 and 4
- B. 2 and 3
- C. 1 and 2 (Correct Answer)
- D. 3 and 4
Maternal-Fetal Medicine Explanation: ***1 and 2***
- **Pulmonary hypertension** is classified as WHO Class IV (highest risk) with maternal mortality rates of 30-50%. It represents a contraindication to pregnancy due to the inability to accommodate increased cardiac output and hemodynamic changes.
- **Aortic coarctation with valvular involvement** is also high-risk (WHO Class III-IV) due to increased risk of aortic dissection, rupture, heart failure, and stroke from the hemodynamic stress of pregnancy, particularly when complicated by valvular disease.
- This combination represents the two conditions with the **highest and most consistently documented maternal mortality risk**.
*1 and 4*
- **Pulmonary hypertension** carries extremely high risk as noted above.
- **Mitral stenosis** risk is severity-dependent: severe MS (valve area <1.0 cm²) is WHO Class III-IV with significant mortality risk (5-15%), while mild-moderate MS is lower risk with proper management.
- While this combination includes high-risk conditions, **aortic coarctation with valvular involvement** (option 2) generally carries higher and more consistent risk than mitral stenosis, particularly compared to non-severe MS cases.
*2 and 3*
- **Aortic coarctation with valvular involvement** is high-risk as described above.
- **Atrial septal defect (ASD)** is typically WHO Class II (low risk) and well-tolerated during pregnancy unless complicated by Eisenmenger syndrome or pulmonary hypertension.
- This pairing incorrectly combines a high-risk condition with a generally low-risk condition.
*3 and 4*
- **Atrial septal defect (ASD)** is generally low-risk (WHO Class II) in uncomplicated cases.
- **Mitral stenosis** varies by severity, but even severe MS carries lower mortality risk than pulmonary hypertension or complicated aortic coarctation.
- This option incorrectly identifies conditions that do not consistently represent the **major/highest** maternal mortality risk compared to pulmonary hypertension and aortic coarctation with valvular involvement.
Maternal-Fetal Medicine Indian Medical PG Question 5: A 32 year old pregnant woman presents with 36 week pregnancy with complaints of pain abdomen and decreased fetal movements. Upon examination PR= 96/min, BP = 156/100 mm Hg, FHR = 128 bpm. On per-vaginum examination there is altered blood seen and cervix is soft 1 cm dilated. What is the preferred management?
- A. Observation and monitoring
- B. Perform cesarean section (Correct Answer)
- C. Initiate labor induction
- D. Administer medications to delay labor
Maternal-Fetal Medicine Explanation: ***Perform cesarean section***
- The clinical presentation strongly suggests **placental abruption**: abdominal pain, decreased fetal movements, hypertension (risk factor), and altered blood per vaginum
- **Decreased fetal movements** with FHR at 128 bpm (lower end of normal) indicates **potential fetal compromise**
- At **36 weeks gestation**, the fetus is viable and immediate delivery is warranted when abruption is suspected with fetal distress
- **Emergency cesarean section** is the preferred management for placental abruption with signs of fetal compromise, as it provides the fastest route to delivery
- Attempting vaginal delivery in suspected abruption with fetal distress risks further compromise and maternal hemorrhage
*Initiate labor induction*
- Labor induction is **contraindicated** in suspected placental abruption with fetal compromise
- Induction takes hours to achieve delivery, during which time the fetus may deteriorate further and maternal bleeding may worsen
- The presence of altered blood, decreased fetal movements, and hypertension makes this a **high-risk scenario** requiring immediate delivery, not a gradual process
- Induction might be considered only in very mild, stable cases of abruption without fetal distress, which is not the case here
*Observation and monitoring*
- The clinical findings indicate an **obstetric emergency** (suspected placental abruption), not a condition suitable for expectant management
- **Decreased fetal movements** are a warning sign of fetal hypoxia requiring immediate action
- Progressive abruption can lead to **maternal hemorrhage, DIC, and fetal death** if not managed promptly
- At 36 weeks with concerning features, continued observation risks catastrophic outcomes
*Administer medications to delay labor*
- **Tocolytics are absolutely contraindicated** in placental abruption
- Delaying delivery when abruption is suspected and fetal compromise is present would worsen both maternal and fetal outcomes
- At 36 weeks gestation, the fetus has adequate maturity and there is no benefit to prolonging pregnancy
- The goal is **expedited delivery**, not pregnancy prolongation
More Maternal-Fetal Medicine Indian Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
