1–1. The field of obstetrics encompasses all EXCEPT 1–8.

A patient presents at 22 weeks’ gestation with

which of the following? spontaneous rupture of membranes and delivers
a. Prenatal care a 489-g male infant who dies at 4 hours of life.
b. Management of labor Her last menstrual period and early sonographic
c. Infertility treatments evaluation confirm her gestational dating. All
d. Immediate newborn care EXCEPT which of the following definitions
accurately apply to this delivery?
1–2. Registration of live births is currently assigned a. Abortus
to which national agency? b. Preterm neonate
a. Bureau of the Census c. Early neonatal death
b. National Institutes of Health d. Extremely low birthweight
c. National Center for Health Statistics
d. Department of Health and Human Services 1–9. A death of a newborn at 5 days of life due to
congenital heart disease would be counted in which
1–3. How does the National Vital Statistics System, of the following rates?
using data from the National Center for Health a. Infant mortality rate
Statistics, b. Perinatal mortality rate
define fetal death for its reports? c. Early neonatal death rate
a. Fetal weight > 350 g d. All of the above
b. Fetal weight > 500 g
c. Gestational age > 20 weeks 1–10. The fertility rate is the number of live births
d. Gestational age > 24 weeks per 1000 females of what age?
a. 9–39 years
1–4. The perinatal period starts after delivery at 20 b. 11–55 years
weeks’ gestation or older. When does it end? c. 15–44 years
a. 7 days after birth d. 18–49 years
b. 1 year after birth
c. 28 days after birth 1–11. Delivery at what age divides preterm from
d. 1 calendar month after birth term gestations?
a. 34 weeks
1–5. Which of the following is synonymous with fetal b. 36 weeks
death rate? c. 37 weeks
a. Stillbirth rate d. 38 weeks
b. Perinatal death rate Overview of Obstetrics 3
c. Spontaneous abortion rate
d. Early neonatal death rate 1–12. Which of the following is an example of an
indirect maternal death?
1–6. At the state level, which of the following is used a. Septic shock following an abortion
to define fetal death? b. Aspiration following an eclamptic seizure
a. Fetal death > 20 weeks’ gestation c. Hemorrhage following a ruptured ectopic
b. Fetal death with a birthweight of ≥ 500 g pregnancy
c. Any fetal death regardless of gestational age d. Aortic rupture at 36 weeks’ gestation in a patient
d. Each has been used with Marfan syndrome

1–7. Which of the following is defined as the sum of 1–13. A patient with no prenatal care presents to
stillbirths and neonatal deaths per 1000 total births? Labor and Delivery with abdominal pain. Her fundal
a. Fetal death rate height is 21 cm. She spontaneous delivers a 475-g
b. Neonatal mortality rate female fetus with no heart rate. According to the
c. Perinatal mortality rate Centers for Disease Control, which of the following
d. None of the above terminology correctly describes the death?
a. Abortus
b. Fetal death
c. Neonatal death
d. None of the above

1–14. A patient presents with severe preeclampsia

at 25 weeks’ gestation. Labor is induced and she
spontaneously delivers a 692-g neonate. In the
recovery room she complains of a severe headache
and suddenly collapses. She is unable to be
resuscitated. An autopsy reveals the following
finding. How would her death be classified?

a. Perinatal death
b. Nonmaternal death
c. Direct maternal death
d. Indirect maternal death

1–18. A 24-year-old primigravida with no prior

prenatal care presents with active preterm labor at
a. Perinatal death 33 weeks’ gestation. Following admission to Labor
b. Nonmaternal death and Delivery, she complains of dyspnea, suddenly
c. Direct maternal death collapses, and is unable to be resuscitated. Her fetus
d. Indirect maternal death dies during attempted maternal resuscitation.
Autopsy of the mother reveals marked right
1–15. The death of the patient in Question 1–14 ventricular hypertrophy, and her peripheral
should also be classified as which of the following? pulmonary arteries microscopically show marked
a. Maternal death hypertrophy of the tunica media. How would her
b. Pregnancy-related death death be classified
c. Pregnancy-associated death
d. All of the above

1–16. Which of the following definitions most

specifically applies to the neonate in the previous
clinical scenario?
a. Low birthweight
b. Growth restricted
c. Very low birthweight
d. Extremely low birthweight

1–17. A 30-year-old multigravida presents with

ruptured membranes at term but without labor.
Following induction with misoprostol, her labor RV = right ventricle;
progresses rapidly, and she spontaneously delivers a LV = left ventricle.
liveborn 3300-g neonate. Immediately after delivery, Used with permission from Dr. David Nelson.
she complains of dyspnea. She becomes apneic a. Perinatal death
and pulseless and is unable to be resuscitated. b. Nonmaternal death
Photomicrographs from her autopsy reveal fetal c. Direct maternal death
squames (arrows) within the pulmonary vasculature. d. Indirect maternal death
How would her death be classified?
1–19. Which of the following is an accurate
statement regarding the birth rate in the United
States?
a. It is at an all-time low.
b. The teenage birth rate has slowly increased in the
past 20 years.
c. The greatest decrease in birth rate has been seen
in women older than 30 years.
d. While the birth rate has fallen in some racial and
ethnic groups, it has increased in other groups.
1–20. Which of the following makes the largest
contribution to infant death in the United States?
a. Home births
b. Multifetal gestations
c. Congenital fetal anomalies
d. Preterm birth < 32 weeks’ gestation
1–21. What percentage of all pregnancies in the
United States end in a live birth?
a. 30%
b. 50%
c. 65%
d. 90%
1–22. Which of the following is an accurate
reflection of fetal death rates between 20 and 28
weeks’ gestation?
a. They have fallen significantly since 1990.
b. They have remained relatively stable since 1990.
c. The fetal mortality rate at 20–27 weeks’ gestation
approximates that at > 28 weeks’ gestation.
d. None of the above
1–23. Which of the following is the largest
contributor to the perinatal mortality rate?
a. Fetal deaths
b. Neonatal deaths
c. Spontaneous abortions < 16 weeks’ gestation
d. None of the above
1–24. Which of the following obstetrical
complications contributes the least to the
pregnancy-related death rate in the United States?
a. Hemorrhage
b. Thromboembolism
c. Ectopic pregnancy
d. Anesthetic complications
1–25. What is the most recent estimate of maternal
mortality in the United States?
a. 4/10,000 live births
b. 14/10,000 live births
c. 14/100,000 live births
d. 41/100,000 live births
1–26. All EXCEPT which of the following is an
example of a “near miss?”
a. A postpartum patient who falls in shower without
injury
b. A delay in sending the human immunodeficiency
virus (HIV) screening test of a laboring patient
who ultimately has a negative test result
c. Failure to give Rh immunoglobulin to an
Rh-negative postpartum patient who ultimately
has no change in antibody screen
d. High spinal anesthesia resulting in intubation,
admission to the intensive-care unit, and a
ventilator-associated pneumonia
1–27. Which of the following is an accurate
statement regarding current health care for women
in the United States?
a. Uninsured women with breast cancer have a 50%
higher mortality rate than insured women.
b. The United States is ranked in the top 10
countries with the lowest neonatal mortality rates.
c. The Affordable Care Act mandates expanded
Medicaid coverage for poor women, improving
availability to prenatal services.
d. The availability of Medicaid coverage for prenatal
care has eliminated disparities in perinatal
outcomes between insured and uninsured
women.
1–28. How are programs supported by Title V
Maternal and Child Health Services Block Grants
funded?
a. States match federally provided funds.
b. States generate revenue through property taxes.
c. Private contributions support individual state
initiatives.
d. A percentage of Social Security revenue is
apportioned for Title V and Title X.
1–29. All EXCEPT which of the following contribute
to the increasing cesarean delivery rate?
1–32. Which of the following is accurate regarding
home births in the United States?
a. Certified nurse midwives attend most home
births.
b. They have a higher associated perinatal mortality
rate than births occurring in medical facilities.
c. Randomized trials suggest their outcomes are
equivalent to those of births occurring in medical
facilities.
d. None of the above

a. Increasing rates of labor dystocia

b. Increasing rates of labor induction
c. Increasing rates of breech presentation
d. Decreasing rates of vaginal birth after cesarean
section

1–30. For which of the following purposes would

fetal chromosomal microarray analysis be potentially
beneficial?
a. Evaluating a stillborn fetus
b. Screening the fetus of an advanced-age mother
c. Evaluating the fetus with trisomy 21 and a
double-outlet right ventricle
d. Screening the fetus at 12 weeks’ gestation whose
mother personally carries a balanced translocation

1–31. Which of the following are reported physician

responses to the current liability environment in the
United States?
a. Higher cesarean delivery rates
b. Reduction in number of obstetric patients
accepted for care
c. Refusal to care for women whose pregnancies are
considered high-risk
d. All of the above