Multiple Pregnancy

 Multiple Pregnancy:

1. Multiple pregnancy increases

A. In white people more than black

B. With advancing maternal age

C. With Bromocriptine use for infertility treatment

D. If first pregnancy

E. After ovarian diathermy for polycystic ovary syndrome

2. In twin deliveries: Which is true?

A. The first twin is at greater risk than the second

B. They usually go post date

C. Epidural analgesia is best avoided

D. Commonest presentation is cephalic and second breach

E. There is increased risk of postpartum hemorrhage

3. The most common cause of uterine size-date disproportion:

A. Fetal macrosomia

B. Polyhydramnios

C. Inaccurate last menstrual period date

D. Multiple pregnancy

E. Molar pregnancy.

4. Which of the following is known to be the commonest presentation in twins?

A. Breech, cephalic

B. Cephalic, breech

C. Cephalic, cephalic

D. Breech, breech

E. Cephalic, transverse

5. The risk of postpartum uterine atony is associated with:

A. Hypotension.

B. Epidural anesthesia.

C. Median episiotomy.

D. Twin pregnancy.

E. Labor associated with an active rate of change of 2.3 cm per hour.

6. The major cause of the increased risk of morbidity & mortality among twin

gestation is:

A. Gestational diabetes.

B. Placenta previa.

C. Malpresentation.

D. Preterm delivery.

All OB-GYN MCQs Second rearranged Edition 2011

48

E. Congenital anomalies.

7. Multiple gestations should be suspected in all of the following condition

EXCEPT:

A. Maternal weight gain is greater than expected.

B. The uterus is larger than expected.

C. Maternal AFP is elevated.

D. Pregnancy has occurred after induction with Gonadotropins.

E. Maternal perception of fetal movement occurs earlier than expected in

gestation.

8. The most common cause of perinatal death in mono-amniotic twin is:

A. Cord entrapment.

B. Cord prolapse.

C. Twin-twin transfusion syndrome.

D. Lethal congenital anomalies.

E. Placental abruption.

9. If twin A is in a transverse lie & twin B is vertex. The most appropriate route for

delivery is:

A. C-section.

B. Internal podalic version followed by breech extraction.

C. Both

D. Neither.

10. All of the following increased in multiple gestation EXCEPT:

A. Blood loss at delivery.

B. The incidence of congenital anomalies.

C. The incidence of cephalo-pelvic disproportion.

D. The incidence of placental abruption.

E. The incidence of Malpresentation.

11. Regarding Hyperemesis gravidarum, which one of the following items is TRUE?

A. Is a complication of multiple pregnancy

B. Not known to happen in molar pregnancy

C. Worsen in missed abortion

D. Liver function test is not required

E. Urine for culture and sensitivity is not important

12. Monozygotic twins, All of the following are correct EXCEPT :

A. Has a constant incidence of 1:250 births

B. Has a constant incidence 1:600 births

C. Is not related to induction of ovulation

D. Constitutes 1/3 of twins

All OB-GYN MCQs Second rearranged Edition 2011

49

E. Is not affected by heredity

13. The following are complications of multiple pregnancy EXCEPT :

A. Increase incidence of pre-eclamptic toxemia

B. Polyhydramnios

C. Increase incidence of preterm labor

D. Increase incidence of gestational diabetes

E. Increase incidence of placenta previa

14. Twins pregnancy :

A. Presentation of the second twin dictate the mode of delivery

B. Internal podalic version should not be performed for the second twin

C. Monozygotic twins always bearing same sex

D. Commonly goes post mature

E. Should be delivered by caesarean section

15. The following are fetal complications in multiple pregnancy EXCEPT :

A. Increase incidence of perinatal mortality & morbidity

B. Increase incidence of prematurity

C. Increase incidence of mal-presentation

D. Increase incidence of congenital abnormalities particularly sacral agenesis

E. Increase incidence of prolapsed cord during labor

16. The following are true for dizygotic twins EXCEPT:

A. Fertilization of more than one egg by more than one sperm

B. Most common type of twins represents 2/3 of cases

C. Both twins are identical & of the same sex.

D. There are two chorions & two amnions

E. Placenta may be separated or fused

17. The following factors affect the incidence of dizygotic multiple pregnancy

EXEPT :

A. Induction of ovulation

B. Increase maternal age

C. Heredity

D. Race

E. Nuliparity

18. The following statements about multiple pregnancy are true EXCEPT:

A. Its occurrence in West Africa.

B. Its incidence is increased by increased age and parity.

C. Twin to twin transfusion common in monochromic twins.

D. Can be diagnosed by ultrasound only after 12 weeks.

E. Associated with induction of ovulation.

All OB-GYN MCQs Second rearranged Edition 2011

50

19. The following are complication of multiple gestation EXCEPT :

A. Increase incidence of pre-eclampsia toxemia

B. Polyhydramnios

C. Increase incidence of premature labor

D. Increase incidence of gestational diabetes

E. Increase incidence of placenta previa

20. Twins can be diagnosed by :

A. Large uterus after delivery of the first twin

B. Uterus bigger than date during pregnancy

C. Ultrasonography

D. Auscultation

E. All of the above

21. The following are common in twins pregnancy EXCEPT :

A. Increase incidence of premature labor

B. Increase incidence of APH

C. Increase incidence PPH

D. Increase incidence perinatal mortality

E. Increase incidence of GDM

22. Regarding twin pregnancies all of the following are correct EXCEPT:

A. It has a higher incidence of preterm labor

B. Mal-presentation of one of the main factors leading to increase incidence

of C/S

C. Abruptio placenta may occur with the sudden decompression of the

uterus immediately after delivery of the first twin

D. Dexamethasone is useful in case preterm labor

E. Identical or monozygotic twin arise from fertilization of two ovum

23. All are true about monozygotic pregnancy, EXCEPT :

A. The 1st commonly presents as breech.

B. Pregnancy induced hypertension is common.

C. There is only one placenta.

D. Polyhydramnios is frequently present.

E. Anemia is common.

24. Excessive increased level of β-HCG is expected in :

A. Ectopic pregnancy.

B. Pregnancy of diabetic mothers.

C. Twin pregnancy.

D. Incomplete abortion.

E. Cervical carcinoma.

All OB-GYN MCQs Second rearranged Edition 2011

51

25. Regarding multiple pregnancy. All the following are true, EXCEPT :

A. Is frequently complicated by premature labor.

B. Is associated with an increased risk of post partum hemorrhage.

C. Occurs in approximately 1 in 80 pregnancies.

D. Often causes prolonged labor.

E. Is often diagnosed early by US.

26. Multiple pregnancy increases:

A. In white people more than black

B. With advancing maternal age

C. With Bromocriptine use for infertility treatment

D. If first pregnancy

E. After ovarian diathermy for polycystic ovary syndrome

27. Multiple Gestation is frequently associated with all of the following EXCEPT:

A. Hypertension.

B. Hydramnios.

C. Fertility drugs.

D. Post-maturity.

E. Pre-term labor.