Prenatal Care Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Prenatal Care. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Prenatal Care Indian Medical PG Question 1: Test done at sub-centre during pregnancy:
- A. Haemoglobin (Correct Answer)
- B. Triple test
- C. USG
- D. OGTT
Prenatal Care Explanation: ***Haemoglobin***
- **Haemoglobin testing** is a routine and essential screening measure performed at the subcenter level during pregnancy, primarily to detect and monitor **anaemia**.
- Its simplicity, cost-effectiveness, and direct impact on maternal and fetal health make it suitable for primary healthcare settings.
*Triple test*
- The **triple test** (or multiple marker screen) is a prenatal diagnostic test for chromosomal abnormalities and neural tube defects, typically performed between weeks 15 and 20 of pregnancy.
- This test requires specialized laboratory facilities and interpretation, which are usually not available or routinely performed at the subcenter level.
*USG*
- **Ultrasonography (USG)** is a vital imaging technique used to monitor fetal growth, development, and maternal health during pregnancy.
- While crucial, USG requires specialized equipment and trained personnel (sonographers or radiologists) and is generally conducted in higher-level healthcare facilities, not routinely at a subcenter.
*OGTT*
- An **Oral Glucose Tolerance Test (OGTT)** is used to screen for **gestational diabetes mellitus**.
- While it is a routine test in pregnancy, performing a full OGTT (which involves multiple blood draws over several hours after glucose ingestion) is often logistically challenging for routine performance at a subcenter; usually, only initial screening (like random blood sugar or fasting glucose) or a single-step glucose challenge test might be done at a primary level before referral.
Prenatal Care Indian Medical PG Question 2: Indications and prerequisites for delivery with the ventouse include which of the following?
1. Delay in the second stage of labour
2. Non-reassuring fetal heart rate
3. Gestation age less than 34 weeks of pregnancy
4. Vertex presentation.
- A. 1, 2 and 4 (Correct Answer)
- B. 2, 3 and 4
- C. 1, 2 and 3
- D. 1, 3 and 4
Prenatal Care Explanation: ***1, 2 and 4***
- **Ventouse delivery** is indicated for **delay in the second stage of labor** and **non-reassuring fetal heart rate**, when expeditious delivery is required.
- A crucial prerequisite is **vertex presentation**, ensuring proper application of the vacuum cup to the fetal head.
*2, 3 and 4*
- **Gestation age less than 34 weeks of pregnancy** is a contraindication for ventouse delivery due to the increased risk of **fetal scalp trauma** and **intracranial hemorrhage** in premature infants.
- While **non-reassuring fetal heart rate** and **vertex presentation** are valid points, the inclusion of premature gestation makes this option incorrect.
*1, 2 and 3*
- Again, **gestation age less than 34 weeks of pregnancy** is a contraindication, not an indication or prerequisite, for ventouse delivery.
- Although **delay in the second stage** and **non-reassuring fetal heart rate** are correct factors, the inclusion of prematurity renders this option incorrect.
*1, 3 and 4*
- This option incorrectly lists **gestation age less than 34 weeks of pregnancy** as a prerequisite.
- While **delay in the second stage** and **vertex presentation** are appropriate, the prematurity contraindication makes this an unsuitable choice.
Prenatal Care Indian Medical PG Question 3: A 20 year old Primigravida, comes at 35 weeks of gestation with complaints of swelling of feet. On examination her blood pressure is 170/110 mm Hg on 2 occasions; urine examination shows proteinuria. Which one of the following statements regarding her management is NOT true?
- A. Injection Dexamethasone is to be given for fetal lung maturity (Correct Answer)
- B. Can be labelled as Preeclampsia
- C. Both maternal and fetal monitoring are required
- D. Requires urgent admission
Prenatal Care Explanation: ***Injection Dexamethasone is to be given for fetal lung maturity***
- At **35 weeks of gestation**, corticosteroids for fetal lung maturity are **traditionally NOT routinely indicated** according to classical obstetric teaching.
- The primary indication for antenatal corticosteroids is between **24 and 34 weeks of gestation**, when the risk of respiratory distress syndrome is highest.
- At 35 weeks, fetal lungs are generally considered sufficiently mature, and the risk-benefit ratio of routine steroid administration changes.
- **Note**: Evolving evidence (post-2016) suggests potential benefits of late preterm steroids (34-36+6 weeks) in certain scenarios, but this was not standard practice at the time of this examination.
- In the context of this question and examination year, this statement is **NOT true** as routine practice.
*Can be labelled as Preeclampsia*
- The patient presents with **severe hypertension** (BP 170/110 mmHg on two occasions) and **proteinuria**, which are the hallmark diagnostic criteria for **severe preeclampsia**.
- BP ≥160/110 mmHg meets the criteria for severe features.
- Swelling of the feet (**edema**) is a common, though not diagnostic, associated symptom.
*Both maternal and fetal monitoring are required*
- In severe preeclampsia, **close maternal monitoring** for signs of worsening disease is crucial:
- Severe hypertension, headaches, visual disturbances, epigastric pain
- Laboratory monitoring: liver enzymes, platelets, creatinine, LDH
- **Fetal monitoring** is essential to assess fetal well-being:
- Non-stress tests, biophysical profiles
- Doppler velocimetry to assess placental insufficiency
- Monitoring for IUGR or fetal distress
*Requires urgent admission*
- With BP 170/110 mmHg and proteinuria at 35 weeks, this is **severe preeclampsia** - a medical emergency.
- **Urgent admission** is necessary for:
- Continuous maternal and fetal monitoring
- Blood pressure control with antihypertensives
- Magnesium sulfate for seizure prophylaxis
- Planning for timely delivery (delivery is the definitive treatment)
Prenatal Care Indian Medical PG Question 4: Which of the following will be target population for screening of diabetes?
- A. People over 40 years of age
- B. People with family history of diabetes
- C. Women who have had a baby weighing more than 4·5 kg
- D. All of the options (Correct Answer)
Prenatal Care Explanation: ***All of the options***
- All listed groups—**people over 40 years of age**, **individuals with a family history of diabetes**, and **women who have had a baby weighing more than 4.5 kg**—are considered high-risk populations for developing diabetes.
- Screening these groups is a **cost-effective strategy** to identify diabetes early, allowing for timely intervention and prevention of complications.
*People over 40 years of age*
- **Age** is a significant risk factor for type 2 diabetes, with incidence progressively increasing after 40 due to decreased insulin sensitivity.
- Routine screening is recommended by guidelines for adults in this age group, regardless of other risk factors.
*People with family history of diabetes*
- A **genetic predisposition** plays a crucial role in the development of type 2 diabetes, making a family history a strong indicator for increased risk.
- Screening is essential for these individuals to detect the condition early, even if they are otherwise asymptomatic.
*Women who have had a baby weighing more than 4·5 kg*
- Delivering a **large-for-gestational-age infant** (macrosomia) is a strong indicator of prior **gestational diabetes (GDM)**, even if not formally diagnosed at the time.
- Women with a history of GDM have a significantly increased risk of developing type 2 diabetes later in life.
Prenatal Care Indian Medical PG Question 5: What is the management of eclampsia at 34 weeks of pregnancy?
- A. Continue convulsions and wait for 37 weeks to complete.
- B. Wait for spontaneous labor.
- C. Continue blood pressure management.
- D. Administer antihypertensives, anticonvulsants, and consider termination of pregnancy. (Correct Answer)
Prenatal Care Explanation: **Administer antihypertensives, anticonvulsants, and consider termination of pregnancy.**
- In eclampsia, emergent management includes immediate administration of **magnesium sulfate** as an anticonvulsant and **antihypertensives** (e.g., labetalol, hydralazine, nifedipine) to control blood pressure.
- Given the gestational age of 34 weeks and the occurrence of eclampsia, **delivery of the fetus** is often indicated to resolve the maternal condition, regardless of fetal lung maturity.
*Continue convulsions and wait for 37 weeks to complete.*
- Allowing **convulsions to continue** is extremely dangerous for both mother and fetus, increasing risks of aspiration, trauma, hypoxemia, and placental abruption.
- Eclampsia is a severe complication of pregnancy that necessitates immediate intervention and **should not be passively observed** until full term.
*Wait for spontaneous labor.*
- **Delaying delivery** while waiting for spontaneous labor in eclampsia significantly prolongs the mother's exposure to the severe complications of the condition.
- Eclampsia is an ** obstetric emergency** where prompt delivery, often via induction or C-section, is the definitive cure.
*Continue blood pressure management.*
- While **blood pressure management** is a crucial component of eclampsia treatment, it is insufficient on its own.
- Eclampsia specifically involves **seizures**, which require anticonvulsant therapy (magnesium sulfate) in addition to antihypertensives, and the ultimate treatment is delivery.
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