Answer: Gravidity is the total number of pregnancies (including current). Parity is the number of pregnancies that reached viability (≥20 weeks or ≥500g). Using GTPAL: G=Gravida, T=Term births, P=Preterm births, A=Abortions, L=Living children.
Answer: Naegele's rule: Add 280 days (40 weeks) to the first day of the last menstrual period (LMP). Alternative: LMP + 9 months + 7 days. First trimester ultrasound is most accurate for dating.
Answer: Severe headache, visual disturbances, epigastric pain, persistent vomiting, vaginal bleeding, loss of fetal movements, regular contractions before 37 weeks, rupture of membranes, severe abdominal pain.
Answer: Depends on pre-pregnancy BMI: Underweight (BMI <18.5): 28-40 lbs; Normal weight (BMI 18.5-24.9): 25-35 lbs; Overweight (BMI 25-29.9): 15-25 lbs; Obese (BMI ≥30): 11-20 lbs.
Answer: Booking bloods (FBC, blood group & antibodies, rubella immunity, syphilis, HIV, hepatitis B), urine dipstick, dating scan (10-13 weeks), anomaly scan (18-20 weeks), glucose tolerance test (24-28 weeks), Group B Strep screening (35-37 weeks).
Answer: Pregnancy-specific condition after 20 weeks characterized by new-onset hypertension (≥140/90 mmHg) plus proteinuria (≥300mg/24h) or other maternal organ dysfunction or uteroplacental dysfunction.
Answer: Nulliparity, previous preeclampsia, family history, chronic hypertension, diabetes, renal disease, autoimmune disease, multiple pregnancy, maternal age >40 or <20, obesity, thrombophilia.
Answer: Glucose intolerance first recognized during pregnancy. Diagnosed by oral glucose tolerance test (75g): fasting glucose ≥5.6 mmol/L or 2-hour glucose ≥7.8 mmol/L.
Answer: Maternal: increased risk of preeclampsia, cesarean delivery, future type 2 diabetes. Fetal: macrosomia, hypoglycemia, respiratory distress syndrome, shoulder dystocia, perinatal mortality.
Answer: Placental implantation in the lower uterine segment, partially or completely covering the internal cervical os. Presents with painless vaginal bleeding in the third trimester.
Answer: Premature separation of a normally implanted placenta before delivery. Presents with painful vaginal bleeding, uterine tenderness, and contractions. Can be concealed or revealed.
Answer: First stage: onset of labor to full cervical dilatation (latent and active phases). Second stage: full dilatation to delivery of baby. Third stage: delivery of baby to delivery of placenta.
Answer: Regular contractions with cervical changes before 37 weeks. Management includes tocolytics, corticosteroids for fetal lung maturity, magnesium sulfate for neuroprotection, and delivery planning.
Answer: Absolute: placenta previa, cord prolapse, uterine rupture. Relative: previous cesarean scar, breech presentation, fetal distress, failure to progress, severe preeclampsia.
Answer: Failure of spontaneous delivery of shoulders after delivery of head. Management: McRoberts maneuver, suprapubic pressure, episiotomy, internal rotation, delivery of posterior arm.
Answer: 4 T's: Tone (uterine atony), Trauma (lacerations), Tissue (retained products), Thrombin (coagulation disorders). Uterine atony is the most common cause.
Answer: Resuscitation, uterine massage, uterotonics (oxytocin, ergometrine, misoprostol), examination for trauma, evacuation of retained products, blood transfusion if needed, surgical intervention if conservative measures fail.
Answer: Maternal: HIV (in developed countries), active TB, certain medications, illicit drug use. Infant: galactosemia, phenylketonuria (relative). Temporary: mastitis, cracked nipples.
Answer: Severe nausea and vomiting in pregnancy leading to dehydration, weight loss >5%, and electrolyte imbalance. Usually occurs in first trimester and may require hospitalization.
Answer: Cervical dilatation, effacement, station, consistency, and position. Each scored 0-3 (position 0-2). Score ≥8 indicates favorable cervix for induction.
Answer: Decreased amniotic fluid volume (<5-8cm on ultrasound). Causes: fetal renal abnormalities, growth restriction, post-term pregnancy, ruptured membranes, placental insufficiency.
Answer: Excessive amniotic fluid volume (>20-25cm). Causes: diabetes, fetal abnormalities (neural tube defects, GI anomalies), multiple pregnancy, hydrops fetalis, idiopathic.
Answer: Fetal weight below 10th percentile for gestational age. Causes: placental insufficiency, maternal hypertension, smoking, infections, fetal anomalies, multiple pregnancy.
Answer: Pregnancy itself, cesarean section, immobility, obesity, previous VTE, thrombophilia, multiple pregnancy, maternal age >35, smoking, dehydration.
Answer: External cephalic version at 37 weeks, planned cesarean section, or vaginal delivery if specific criteria met. Depends on type of breech, fetal weight, and maternal factors.
Answer: Threatened (bleeding, closed cervix), inevitable (bleeding, open cervix), incomplete (partial passage), complete (all products passed), missed (fetal death, closed cervix), septic (infection).
Answer: Implantation outside the uterine cavity, most commonly in fallopian tubes. Presents with pain, bleeding, and may cause rupture and hemorrhage.
Answer: Previous ectopic pregnancy, PID, tubal surgery, IUD use, smoking, assisted reproduction, endometriosis, previous abdominal surgery.
Answer: Abnormal pregnancy with abnormal placental development. Complete mole: no fetal tissue, diploid paternal chromosomes. Partial mole: fetal tissue present, triploid chromosomes.
Answer: Effacement: thinning of cervix (0-100%). Dilatation: opening of cervix (0-10cm). Primigravida: effacement then dilatation. Multigravida: simultaneous effacement and dilatation.
Answer: Prophylactic oxytocin, controlled cord traction, and uterine massage. Reduces risk of postpartum hemorrhage compared to physiological management.
Answer: High-risk pregnancies, oxytocin augmentation, epidural anesthesia, meconium-stained liquor, prolonged labor, maternal pyrexia, previous cesarean section.
Answer: May indicate fetal hypoxia. Increases risk of meconium aspiration syndrome. Requires continuous fetal monitoring and pediatric team availability at delivery.
Answer: Previous classical or T-shaped incision, previous uterine rupture, other uterine surgery, medical contraindications to vaginal delivery, inability to perform emergency cesarean.
Answer: Screening at 35-37 weeks. If positive, intrapartum antibiotic prophylaxis with penicillin or ampicillin to prevent neonatal sepsis.
Answer: Regular contractions before 37 weeks, pelvic pressure, low back pain, change in vaginal discharge, cramping, rupture of membranes.
Answer: Confirm rupture, assess gestational age, exclude infection, steroids if <34 weeks, antibiotics if indicated, delivery planning based on gestational age and maternal condition.
Answer: Preterm labor, growth restriction, preeclampsia, gestational diabetes, anemia, polyhydramnios, malpresentation, cord accidents, twin-to-twin transfusion syndrome.
Answer: Pelvic girdle pain due to increased mobility of sacroiliac joints and symphysis pubis during pregnancy. Managed with physiotherapy, support belts, and pain relief.
Answer: Cardiovascular: increased blood volume, cardiac output, decreased BP in 2nd trimester. Respiratory: increased tidal volume, decreased functional residual capacity. Renal: increased GFR, glucosuria.
Answer: Dietary modifications, ginger, vitamin B6, antihistamines (cyclizine), metoclopramide, ondansetron for severe cases. Hospitalization for hyperemesis gravidarum.
Answer: Previous depression, family history, poor social support, unplanned pregnancy, relationship problems, financial stress, complicated delivery, baby blues lasting >2 weeks.
Answer: Psychological support, cognitive behavioral therapy, antidepressants (compatible with breastfeeding), social support, treatment of underlying medical conditions.
Answer: Fetal sleep cycles, oligohydramnios, placental insufficiency, fetal growth restriction, medications, maternal position, fetal death. Requires urgent assessment.
Answer: Detailed history, fetal heart rate monitoring, biophysical profile, ultrasound for growth and liquor volume, consider delivery if compromised.
Answer: Post-term pregnancy, preeclampsia, diabetes, fetal growth restriction, oligohydramnios, maternal medical conditions, intrauterine fetal death.
Answer: Prostaglandins (PGE2 gel/pessary, misoprostol), artificial rupture of membranes, oxytocin infusion. Choice depends on Bishop score and clinical situation.
Answer: Hypotension, prolonged second stage, increased instrumental delivery rate, rare complications: dural puncture, total spinal block, neurological damage.
Answer: Emergency cesarean section, elevation of presenting part, knee-chest position, avoid handling cord, tocolytics if needed, delivery within 30 minutes.
Answer: Previous cesarean section, grand multiparity, malpresentation, placenta previa, severe asthma, glaucoma, cardiac disease, ruptured membranes with infection.
Answer: Average 28 days (range 21-35), menstruation 3-7 days, blood loss 5-80ml. Follicular phase: FSH stimulates follicle development. Ovulation: LH surge. Luteal phase: progesterone preparation for implantation.
Answer: Primary: absent periods by age 16. Secondary: absence for 6 months in previously menstruating woman. Causes: pregnancy, PCOS, hypothalamic dysfunction, pituitary disorders, ovarian failure, uterine abnormalities.
Answer: Endocrine disorder with insulin resistance, hyperandrogenism, and ovulatory dysfunction. Diagnosed by Rotterdam criteria: 2 of 3 features: oligo/anovulation, hyperandrogenism, polycystic ovaries on ultrasound.
Answer: Metabolic: diabetes, cardiovascular disease, obesity. Reproductive: infertility, pregnancy complications, endometrial cancer. Psychological: depression, anxiety, reduced quality of life.
Answer: Presence of endometrial tissue outside the uterus. Causes cyclical pain, dysmenorrhea, dyspareunia, infertility. Diagnosed by laparoscopy. Treatment: hormonal suppression, surgery, pain management.
Answer: Dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, dysuria, infertility, cyclical symptoms, bloating, fatigue. Pain may be cyclical or constant.
Answer: Infection of upper genital tract including endometrium, fallopian tubes, and ovaries. Usually sexually transmitted. Causes: chlamydia, gonorrhea, anaerobes. Can lead to tubal infertility.
Answer: Tubal infertility, ectopic pregnancy, chronic pelvic pain, tubo-ovarian abscess, Fitz-Hugh-Curtis syndrome (perihepatic adhesions), increased risk of hysterectomy.
Answer: Overgrowth of anaerobic bacteria displacing normal lactobacilli. Causes fishy-smelling discharge, pH >4.5, clue cells on microscopy. Treated with metronidazole or clindamycin.
Answer: Fungal infection usually caused by Candida albicans. Symptoms: itching, burning, thick white discharge, dyspareunia. Risk factors: diabetes, antibiotics, pregnancy, immunosuppression.
Answer: Stress: urine loss with increased abdominal pressure. Urge: sudden urge to urinate with involuntary loss. Mixed: combination of both. Overflow: retention with dribbling.
Answer: Conservative: pelvic floor exercises, weight loss, bladder training. Medical: topical estrogen, duloxetine. Surgical: mid-urethral slings, colposuspension, urethral bulking agents.
Answer: Descent of uterus through vaginal canal due to weakened pelvic floor support. Graded 1-4 based on descent. Causes: childbirth, aging, obesity, chronic cough, constipation.
Answer: Functional: follicular, corpus luteum. Pathological: dermoid, endometriotic, cystadenomas. Malignant: epithelial, germ cell, sex cord-stromal tumors. Most are benign and resolve spontaneously.
Answer: Persistent abdominal distension, early satiety, pelvic/abdominal pain, urinary symptoms, weight loss, ascites, palpable mass. Symptoms are often vague and nonspecific.
Answer: Functional cysts: observation, hormonal contraception. Complex cysts: tumor markers, imaging, surgical evaluation. Depends on age, size, characteristics, and symptoms.
Answer: Benign smooth muscle tumors of uterus. Estrogen-dependent. Symptoms: heavy menstrual bleeding, pelvic pain, pressure symptoms, infertility. Treatment depends on symptoms and fertility desires.
Answer: Medical: tranexamic acid, hormonal treatments, GnRH agonists, ulipristal acetate. Surgical: myomectomy, hysterectomy, uterine artery embolization, MRI-guided focused ultrasound.
Answer: Any bleeding pattern that differs from normal menstruation. Includes heavy, prolonged, frequent, or irregular bleeding. Causes: structural (fibroids, polyps) or non-structural (hormonal, coagulation disorders).
Answer: Endometrial atrophy (most common), endometrial cancer, hormone therapy, endometrial polyps, cervical cancer, vulvar/vaginal pathology. Requires urgent investigation.
Answer: Transvaginal ultrasound (endometrial thickness), hysteroscopy, endometrial biopsy, cervical cytology, examination. Endometrial thickness >4mm warrants further investigation.
Answer: Vasomotor: hot flashes, night sweats. Genitourinary: vaginal dryness, dyspareunia, urinary symptoms. Psychological: mood changes, sleep disturbance, cognitive changes. Long-term: osteoporosis, cardiovascular disease.
Answer: Treatment with estrogen ± progestin to alleviate menopausal symptoms. Benefits: symptom relief, bone protection. Risks: VTE, stroke, breast cancer (combined HRT), gallbladder disease.
Answer: Absolute: breast cancer, endometrial cancer, VTE, stroke, liver disease, undiagnosed vaginal bleeding. Relative: gallbladder disease, migraine with aura, hypertension, diabetes.
Answer: Cytology (Pap smear) every 3 years ages 21-29, HPV testing every 5 years ages 30-65. Detects precancerous changes. Abnormal results require colposcopy and possible biopsy.
Answer: HPV infection (especially types 16, 18), smoking, immunosuppression, multiple sexual partners, early sexual activity, high parity, long-term oral contraceptive use, DES exposure.
Answer: Detailed examination of cervix using magnification after abnormal cytology. Acetic acid applied to identify abnormal areas. Biopsies taken from abnormal areas. Treatment can be performed simultaneously.
Answer: CIN 1: observation (often regresses). CIN 2-3: excision (LEEP, cold knife cone, laser) or ablation (cryotherapy, laser). Follow-up cytology essential.
Answer: History, examination, basic investigations (semen analysis, ovulation assessment, tubal patency). Treatments: ovulation induction, IUI, IVF, surgery for tubal disease or endometriosis.
Answer: Ovulatory disorders (35%), tubal factors (20%), endometriosis (15%), uterine/cervical factors (10%), unexplained (20%). Age-related decline in ovarian reserve is increasingly common.
Answer: Assisted reproductive technology involving ovarian stimulation, egg retrieval, fertilization in laboratory, embryo transfer. Success rates depend on age, cause of infertility, and clinic factors.
Answer: Ovarian hyperstimulation syndrome, multiple pregnancy, ectopic pregnancy, ovarian torsion, infection, psychological stress, financial burden. Long-term cancer risk unclear.
Answer: Complication of ovarian stimulation with enlarged ovaries, fluid retention, and electrolyte imbalance. Severe cases can be life-threatening. Prevention: careful monitoring, trigger timing.
Answer: Barrier: condoms, diaphragm. Hormonal: pills, patches, rings, injections, implants. Intrauterine: copper, hormonal. Permanent: sterilization. Emergency: pills, copper IUD.
Answer: Thrombotic disease, cerebrovascular disease, ischemic heart disease, complicated migraine, breast cancer, severe liver disease, undiagnosed vaginal bleeding, pregnancy.
Answer: Prevention of pregnancy after unprotected intercourse. Options: levonorgestrel (within 72 hours), ulipristal acetate (within 120 hours), copper IUD (within 120 hours, most effective).
Answer: Primary: painful periods without underlying pathology, caused by prostaglandins. Secondary: painful periods due to underlying condition (endometriosis, fibroids, PID). Treatment: NSAIDs, hormonal contraceptives.
Answer: Physical and psychological symptoms occurring in luteal phase, resolving with menstruation. Symptoms: bloating, breast tenderness, mood changes, irritability. Severe form: premenstrual dysphoric disorder (PMDD).
Answer: Lifestyle modifications, dietary changes, exercise, stress management, vitamin B6, evening primrose oil. Severe cases: hormonal contraceptives, antidepressants, GnRH agonists.
Answer: Excessive hair growth in androgen-dependent areas in women. Causes: PCOS, congenital adrenal hyperplasia, androgen-secreting tumors, medications. Investigation: testosterone, DHEAS, 17-OHP.
Answer: Treat underlying cause, cosmetic measures (laser, electrolysis), anti-androgens (cyproterone acetate, spironolactone), topical eflornithine, weight loss in PCOS.
Answer: Gynecological: endometriosis, adhesions, ovarian cysts, PID. Non-gynecological: IBS, interstitial cystitis, musculoskeletal pain, nerve entrapment. Often multifactorial.
Answer: Detailed history, examination, basic investigations (FBC, inflammatory markers, STI screen), ultrasound, laparoscopy if indicated. Multidisciplinary approach often needed.
Answer: Presence of endometrial tissue within myometrium. Causes heavy menstrual bleeding, dysmenorrhea, enlarged uterus. Diagnosed by MRI or ultrasound. Treatment: hormonal, hysterectomy.
Answer: Chronic vulvar pain without identifiable cause. Symptoms: burning, stinging, irritation. Types: generalized or localized (vestibulodynia). Treatment: topical anesthetics, antidepressants, anticonvulsants, physiotherapy.
Answer: Chronic inflammatory condition affecting vulvar skin. Causes itching, pain, white patches, scarring. Risk of malignant transformation. Treatment: topical corticosteroids, regular follow-up.
Answer: Address psychological factors, relationship issues, medical causes. Treatments: counseling, hormonal therapy, topical preparations, lifestyle modifications, specialist referral.
Answer: Pregnancy (most common), PCOS, hypothalamic dysfunction, pituitary disorders, ovarian failure, thyroid disorders, hyperprolactinemia, Asherman's syndrome, medications.
Answer: Pregnancy test, hormonal profile (FSH, LH, prolactin, TSH, testosterone), progestogen challenge test, pelvic ultrasound, karyotype if indicated, MRI pituitary if prolactin elevated.
Answer: Intrauterine adhesions usually following uterine surgery or infection. Causes amenorrhea, reduced menstrual flow, infertility, recurrent pregnancy loss. Treatment: hysteroscopic adhesiolysis, hormone therapy.