Prenatal Care Practice Questions

Q: A 34-year-old woman presents at 6 weeks of delivery. She wants contraception for the next 3 years. What will be the best contraceptive method in this case?

Copper T. ***Copper T*** - A **Copper T intrauterine device (IUD)** is an excellent choice for long-term contraception (up to 10 years), making it suitable for her 3-year requirement. - It's **non-hormonal**, making it safe for breastfeeding mothers and avoiding potential hormonal side effects. *Nothing besides lactation amenorrhea* - **Lactational amenorrhea method (LAM)** is effective for only the first six months postpartum, provided the mother is exclusively breastfeeding and her periods have not returned. - It is not a reliable method for contraception beyond six months postpartum or for the requested 3-year duration. *IUCD with progesterone* - An **intrauterine device (IUD) with progesterone** (e.g., Mirena) can be a good long-term option, but it releases hormones which can potentially affect breastfeeding, especially if initiated very early postpartum. - While generally safe for breastfeeding, a non-hormonal option like the copper T is often preferred if there are concerns about hormonal exposure or side effects. *Injectable progesterone* - **Injectable progesterone** (e.g., Depo-Provera) is an effective contraceptive, but it needs to be administered every 3 months. - While safe for breastfeeding, it's not considered as convenient for a 3-year duration as a single-insertion IUD, and some women experience side effects like irregular bleeding or weight gain.

Q: What is the typical time between fertilization and implantation?

8 days. ***8 days*** - **Fertilization** typically occurs in the **fallopian tube**, and the resulting **zygote** then undergoes several cell divisions while migrating towards the uterus. - Implantation, the process by which the **blastocyst embeds into the uterine wall**, usually begins around day 6 post-fertilization and is completed by day 8-10. *2 days* - At 2 days post-fertilization, the embryo is typically in the **2-cell to 4-cell stage** and is still located within the fallopian tube, far from the implantation site. - This stage is too early for implantation to occur, as the embryo has not yet reached the **blastocyst stage** or the uterus. *14 days* - By 14 days post-fertilization, implantation would have long been completed, and the initial stages of **trophoblast development** and formation of the **placenta** would be underway. - This time frame represents a more advanced stage of pregnancy, whereas implantation is an early event. *16 days* - Sixteen days post-fertilization is well past the window for initial implantation; at this point, significant embryonic development has occurred, and the woman might even be experiencing early signs of **pregnancy**, such as a missed period. - Implantation is a much earlier process, concluding by day 10 at the latest.

Question 1

A 25-year-old woman, G1P0, at 30 weeks of gestation is brought to the emergency department with sudden-onset painless bright red vaginal bleeding. She reports two prior episodes of spotting over the past 3 weeks. Vital signs: BP 110/70 mmHg, HR 98 bpm, RR 16/min. Fetal heart rate tracing shows a baseline of 145 bpm with moderate variability and no decelerations. Transabdominal ultrasound shows placenta completely covering the internal os. Which of the following is the most appropriate immediate management?

Accepted Answer

Administer betamethasone, initiate pelvic rest, and admit for monitoring

Answer

Administer betamethasone and plan for delivery at 34 weeks if bleeding stops

Answer

Perform digital cervical examination to assess for labor

Answer

Proceed with immediate cesarean delivery given recurrent bleeding

Answer

Initiate tocolysis with indomethacin and administer betamethasone

Question 2

A 25-year-old G1P0 woman at 32 weeks of gestation presents with sudden-onset painless vaginal bleeding. She reports soaking two pads in the past hour. She denies contractions, leaking fluid, or trauma. Vital signs: BP 110/70 mmHg, HR 102 bpm, RR 18/min, SpO₂ 99%. Fetal heart rate tracing is Category I. Transabdominal ultrasound of the lower uterine segment demonstrates complete placenta previa, with the placenta completely covering the internal cervical os. Based on the ultrasound findings, which of the following is the most appropriate immediate management?

Accepted Answer

Administer betamethasone and admit for expectant management with pelvic rest

Answer

Perform immediate cesarean delivery under general anesthesia

Answer

Perform a digital cervical examination to assess dilation

Answer

Administer tocolytics and transfer to a tertiary care center

Answer

Obtain a Kleihauer-Betke test and initiate Rh immunoglobulin

Question 3

A 34-year-old woman presents at 6 weeks of delivery. She wants contraception for the next 3 years. What will be the best contraceptive method in this case?

Accepted Answer

Copper T

Answer

Nothing besides lactation amenorrhea

Answer

IUCD with progesterone

Answer

Injectable progesterone

Question 4

A GSP4 woman comes for routine sonography for the first time. She has four daughters and expresses a desire for a boy this time, asking for sex determination. To abide by ethical guidelines, what should you do?

Accepted Answer

Check routine ANC and sex for developmental abnormalities and do not reveal gender to the patient

Answer

Check routine ANC and sex for developmental abnormalities and do reveal gender to the patient

Answer

Do reveal gender if a girl

Answer

Check only routine ANC, do not check sex

Question 5

What is the typical time between fertilization and implantation?

Accepted Answer

8 days

Answer

2 days

Answer

14 days

Answer

16 days

Prenatal Care — MCQs

Prenatal Care — MCQs

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