Practice Questions – Maternal Medicine SBA

1. 30 years old Primigravida at 34+ weeks presented with severe itching including the palms and soles and is worse at night. Her liver function tests were normal, and emollients did not give her relief. Your consultant starts her on ursodeoxycholic acid(UDCA) and antihistamines. All the statements are false regarding obstetric cholestasis (OC) except,

2. A 34 year-old woman is 16 weeks pregnant in her third pregnancy. Her blood pressure is 155/105 mmHg; 4 weeks earlier, it was 160/102 mmHg. Her urine dipstick shows + protein. Her spot urinary protein/creatinine ratio is 40mg/mmol. Which one of the following is considered the most likely diagnosis?

3. 40 year old primigravida has just identified that she is pregnant at 34 days of amenorrhoea. She is a known chronic hypertensive on captopril. What is the most appropriate management?

4. 31 year old P1L1 was delivered 6 weeks before at 28 weeks of gestation due to severe pre-eclampsia and HELLP syndrome. During her postnatal review, her BP is found to be normal and she was on anti-hypertensives for 2 weeks following delivery. She is very anxious that she may develop pre-eclampsia again in the subsequent pregnancy. What is the risk of recurrence of pre-eclampsia in her subsequent pregnancy?

5. 32 year old woman has presented with obstetric cholestasis at 35 weeks of gestation. She was put on menandiol sodium phosphate of 10 mg daily in view of prolonged prothrombin time. Which of the following complications is likely to happen to the neonate in this scenario?