Welcome to your 🤰 Antenatal Care, Maternal Assessment, Fetal Wellbeing & Prenatal Diagnosis Arena — 40 MCQs
1.
A 30-year-old primigravida presents for antenatal assessment at 24 weeks of gestation. During abdominal examination, the clinician measures the distance from the upper border of the symphysis pubis to the uterine fundus. What is the main purpose of this measurement?
2.
A 29-year-old woman at 26 weeks of gestation has a booking BMI of 34 kg/m² and a previous history of delivering a 4.3 kg infant. A 75-g oral glucose tolerance test shows fasting plasma glucose of 5.4 mmol/L and a two-hour value of 8.8 mmol/L. Using commonly applied WHO diagnostic thresholds for gestational diabetes, what is the most appropriate interpretation?
3.
A 30-year-old woman at 38 weeks undergoes fetal monitoring because of reduced movements. The cardiotocograph demonstrates a baseline fetal heart rate of 170/min, minimal variability, and recurrent late decelerations following uterine contractions. Which interpretation is most appropriate?
4.
A 27-year-old pregnant woman attends a routine antenatal visit. Urine dipstick testing reveals glucose, but she has no symptoms. The clinician explains that glycosuria may occur physiologically during pregnancy but does not reliably diagnose gestational diabetes. What is the appropriate next principle?
5.
A 23-year-old primigravida attends an antenatal visit at 18 weeks. She asks why folic acid supplementation is emphasized around conception and early pregnancy. Which fetal abnormality is most directly reduced by adequate periconceptional folate supplementation?
6.
A 28-year-old woman at 18 weeks of gestation is referred after an ultrasound identifies increased fetal nuchal fold thickness and a suspected cardiac defect. She has not previously undergone aneuploidy screening. The clinician discusses further assessment with the couple. Which counselling statement is most appropriate?
7.
A 36-year-old pregnant woman undergoes prenatal screening because of advanced maternal age. Following counselling, she requests a test that can provide diagnostic information about fetal chromosomal abnormalities. Which procedure obtains fetal genetic material through sampling of amniotic fluid?
8.
A 28-year-old pregnant woman attends a routine antenatal visit at 28 weeks. Her blood pressure is 150/96 mmHg on repeated measurement, and urine dipstick testing shows proteinuria. Which pregnancy-related complication should be suspected?
9.
A 26-year-old woman at 24 weeks has dysuria and urinary frequency. She is afebrile, with no flank pain or uterine contractions. Urine dipstick is positive for nitrites and leukocyte esterase. A urine sample is sent for culture. Which management approach is most appropriate?
10.
A 33-year-old woman at 30 weeks of gestation undergoes an ultrasound examination because of suspected fetal growth restriction. Doppler assessment of the umbilical artery is requested. What is the main physiological information provided by this investigation?
11.
A 27-year-old pregnant woman at 16 weeks attends antenatal clinic after a previous pregnancy complicated by a fetus with a major congenital anomaly. She asks about the difference between prenatal screening and diagnostic testing. Which explanation is most accurate?
12.
A 35-year-old pregnant woman with a BMI of 38 kg/m² attends her booking visit. The clinician explains that obesity increases the likelihood of certain pregnancy complications. Which condition is particularly associated with maternal obesity?
13.
A 29-year-old woman at 32 weeks has hypertension and suspected fetal growth restriction. Ultrasound shows reduced amniotic fluid volume, while Doppler assessment indicates increased resistance in the umbilical artery. Which underlying placental process most plausibly explains these findings?
14.
A 30-year-old woman and her husband attend a reproductive health clinic because they have been unable to conceive despite regular unprotected intercourse for 18 months. The woman has regular menstrual cycles, and neither partner has previously undergone fertility assessment. What is the most appropriate initial approach?
15.
A 26-year-old woman attends her first antenatal visit at 10 weeks of gestation. She has no medical illness and reports no pregnancy-related complaints. The obstetrician explains that regular antenatal care is important even in an uncomplicated pregnancy. What is the principal purpose of antenatal care?
16.
A 34-year-old multiparous woman attends antenatal care at 30 weeks. Her previous pregnancy ended in spontaneous delivery at 32 weeks following painless cervical dilatation. In the current pregnancy, she was found to have a short cervix on transvaginal ultrasonography at 19 weeks. Which mechanism most directly explains the increased risk of recurrent early delivery?
17.
A 25-year-old woman at 21 weeks undergoes a detailed anomaly scan. The sonographer identifies an open spinal defect, associated cranial abnormalities, and abnormal positioning of the cerebellum. The patient had not taken folic acid before conception. Which diagnosis best explains the combined findings?
18.
A 23-year-old woman at 28 weeks reports increasing fatigue. Her hemoglobin is 8.7 g/dL, mean corpuscular volume is 69 fL, and serum ferritin is 7 ng/mL. She has been taking oral iron inconsistently because of constipation. Which intervention is most appropriate initially, assuming she is clinically stable?
19.
A 31-year-old woman at 36 weeks of gestation undergoes abdominal examination. The clinician palpates a firm, round, ballotable fetal part in the uterine fundus and a softer irregular part in the lower uterine segment. Which fetal presentation is most likely?
20.
A 31-year-old woman at 29 weeks of gestation reports persistent headache and visual blurring. Her blood pressure is 168/112 mmHg on repeat measurement. Urine protein is positive, and platelet count is 85 × 10⁹/L. Which is the most appropriate immediate approach?
21.
A 28-year-old primigravida at 31 weeks has a symphysis-fundal height of 27 cm. Ultrasound shows an estimated fetal weight below the 10th centile, reduced abdominal circumference, and elevated umbilical artery resistance. The fetal head circumference is relatively preserved. Which explanation best accounts for this pattern?
22.
A 37-year-old pregnant woman at 13 weeks undergoes cell-free fetal DNA screening. The result indicates a high probability of trisomy 21. Ultrasound shows increased nuchal translucency, but no major structural abnormality is identified. The couple requests a definitive diagnosis before making further decisions. What is the most appropriate recommendation?
23.
A 26-year-old woman at 14 weeks of gestation undergoes routine antenatal blood grouping. She is RhD-negative, and her partner is RhD-positive. Why is maternal red-cell antibody screening important during pregnancy?
24.
A 24-year-old pregnant woman attends an antenatal clinic at 30 weeks. Her symphysis-fundal height is smaller than expected for gestational age on repeated assessment. Which investigation is most appropriate for further evaluation of fetal growth?
25.
A 35-year-old woman at 25 weeks undergoes antenatal examination. Her blood pressure is 132/82 mmHg, and the fetal heart rate is 145/min. She reports intermittent lower abdominal discomfort without bleeding. On abdominal palpation, the uterus is relaxed between episodes, and there is no tenderness. What is the most appropriate clinical approach?
26.
A 32-year-old woman at 12 weeks of gestation undergoes routine antenatal screening. Her complete blood count reveals hemoglobin of 9.2 g/dL with microcytic, hypochromic red blood cells. Which nutritional deficiency is the most likely explanation?
27.
A 29-year-old woman attends a fertility clinic after two years of unsuccessful attempts to conceive. She has irregular menstrual cycles occurring every 45–70 days, acne, and increased facial hair. Her partner's semen analysis is normal, and pelvic ultrasonography shows polycystic ovarian morphology. Which is the most likely mechanism contributing to infertility?
28.
A 33-year-old woman at 28 weeks undergoes antenatal review. Her booking BMI was 41 kg/m², and she reports exertional breathlessness. Blood pressure is 142/92 mmHg, and urine dipstick is negative for protein. She asks why her pregnancy requires additional monitoring. Which response best reflects an appropriate risk-based approach?
29.
A 27-year-old primigravida attends her booking visit at 11 weeks of gestation. She has a history of chronic hypertension treated with losartan and is currently asymptomatic. Her blood pressure is 138/86 mmHg, and renal function is normal. Which is the most appropriate management decision?
30.
A 30-year-old primigravida at 33 weeks has a fetal growth scan showing an estimated fetal weight at the 5th centile. Amniotic fluid is reduced, and umbilical artery Doppler demonstrates absent end-diastolic flow. The mother has chronic hypertension. Which interpretation is most appropriate?
31.
A 29-year-old woman at 34 weeks of gestation reports that her baby has been moving less than usual during the preceding day. She has no vaginal bleeding or abdominal pain. Which clinical concern should be prioritized?
32.
A 30-year-old woman at 32 weeks of gestation undergoes a non-stress test because of concern about fetal wellbeing. The recording demonstrates accelerations in fetal heart rate associated with fetal movements. What does this finding generally indicate?
33.
A 27-year-old pregnant woman attends her antenatal appointment at 26 weeks. Her clinician recommends screening for gestational diabetes because pregnancy may produce increased insulin resistance. Which placental hormone contributes importantly to this physiological change?
34.
A 32-year-old woman at 35 weeks reports reduced fetal movements for six hours. She has gestational hypertension, and her previous growth scan suggested a small-for-gestational-age fetus. Her blood pressure is 146/94 mmHg, and fetal heart sounds are present on handheld Doppler. What is the most appropriate next step?
35.
A 28-year-old woman at 34 weeks of gestation undergoes fetal biophysical profile assessment because of reduced fetal movements. Which combination of observations is included in the conventional biophysical profile?
36.
A 29-year-old woman with a history of previous pre-eclampsia attends her first antenatal visit. The clinician considers preventive measures because she has an increased risk of recurrence. Which medication is commonly recommended for pre-eclampsia prevention in appropriately selected high-risk pregnancies?
37.
A 34-year-old woman undergoes first-trimester screening for fetal chromosomal abnormalities. Her screening result indicates an increased probability of trisomy 21. What is the most appropriate interpretation of this result?
38.
A 25-year-old primigravida attends her antenatal clinic at 20 weeks. The clinician requests a routine fetal anomaly ultrasound scan. What is the primary purpose of this examination?
39.
A 24-year-old woman attends her first antenatal visit at 15 weeks. She reports that her last menstrual period was uncertain because her cycles were irregular. An ultrasound performed at 9 weeks documented a crown-rump length corresponding to 9 weeks and 3 days. A repeat scan now gives a slightly different gestational age. Which dating method should guide her expected date of delivery?
40.
A 32-year-old woman presents at 20 weeks for antenatal review. Her previous pregnancy was complicated by gestational diabetes, and her booking BMI was 36 kg/m². She reports frequent consumption of sugar-sweetened drinks and minimal physical activity. Which counselling strategy is most appropriate?
