1. EARLY PREGNANCY DATING: FROM LMP 280 days Naegler’s rule
Short cycle vs. long cycle
HEGAR’S SIGN - soft uterus
CHADWICKS SIGN - blue cervix

2. Which of the following statements best describes the foramen ovale:
a) it shunts blood from right to left
b) it connects the pulmonary artery with the
aorta
c) it shunts deoxygenated blood into the
left atrium
d) it is an extra cardiac shunt
e) it is functional after birth

3. Other uses BHCG a sub unit similar to TSH LH FSH
RIA days post conception
8 days
8 weeks
16 weeks
5,000
Level
100,000
doubling time 2 days
Other uses
Zone
Mole
Ectopic
Ovarian cysts
ROLE stimulate CL
progesterone
Other placental hormones HPL = placental mass
PROLACTIN “growth hormone”
PROGESTERONE
ESTROGEN

4. ANTEPARTUM HISTORY ROUTINE TESTS AGE ( > 35 = AMNIOCENTESIS
PURITY / GRAVIDITY
MEDICAL HISTORY
FAMILY HISTORY
ROUTINE TESTS HB
GROUP, RHESUS
SICKLE, THAL,
V.D.R.L.
RUBELLA/chicken pox
HEPATITIS
URINE CULTURE
28 WEEK GLUCOSE SCREEN
Grp B strep
VAG. SWABS
HIV
ULTRASOUND
IPS
SPECIAL TESTS
CVS
AMNIOCENTESIS

5. a FP SCREEN 16 WKS LEVEL > 2 . 5 MOM 2. . 5 - 2 . 9 > 5
> 5
LEVEL < MOM
20 % RISK
70 %
DOWN ‘ S RISK

6. FIRST TRIMESTER 10 TO 14 WEEKS
MSS AT 15 TO 19 WEEKS
AFP, ESTRIOL, HCG
AGE, WEIGHT
RISK CALCULATION WITH ARBITRARY CUT-OFF
DETECTS 60-70% OF DOWNS
FIRST TRIMESTER 10 TO 14 WEEKS
NUCHAL THICKNESS, BHCG, PAPP A
INTEGRATED PRENATAL SCREEN
MSS PLUS FIRST TRIMESTER
DETECTS >90%, FALSE POSITIVE 2%

7. All of the following hormones are products
of placental synthesis or production except:
a) human chorionic gonadotropin
b) human placental lactogen
c) prolactin
d) progesterone
e) estriol

8. PLASMA
H2O

9. ANTENATAL CARE F IRST VISIT GENERAL EXAM PAP HISTORY / RISK FACTORS
4 weekly to 28 weeks
2 weekly to 36 weeks
1 weekly to delivery
EACH VISIT CHECK:
FUNDAL HEIGHT
( CMS )
12 WKS = SYMPHYSIS
20 WKS = UMBILICUS
36 WKS = XIPHISTERNUM
MATERNAL WEIGHT / SYMPTOMS
BLOOD PRESSURE
URINE
PRESENTATION

10. MATERNAL PHYSIOLOGY RBC PLASMA VOLUME 50 %
CARDIAC OUTPUT - highest 1st hour after delivery
HEART RATE %
STROKE VOLUME
Placenta blood flow
= 750 ml / min at
term
Tidal volume
Residual volume
G F R
creatinine cc
glycOSURIA
“normal proteinura” 0.3 g/l

11. All of the following factors are associated with
an increased risk of perinatal morbidity except:
a) low socioeconomic status
b) low maternal age
c) heavy cigarette smoking
d) alcohol abuse
e) exercise