Hello !!!

Greetings !! It’s been some time since we last spoke. We want to apologize for the absence of daily quizzes on Obgresource. However, we’re happy to let you know that we’re back with even more challenging brainteasers. Keep an eye out for them!This week’s topic […]

Lessons from MBRRACE

I am reading the 2020 MBBRACE report and think that many of us will benefit from bite sized learnings. MBBRACE is the report of confidential inquiries into maternal deaths in UK. The lessons learnt are may help in reducing maternal mortality and morbidity. The report […]

This Week’s Topic- Maternal Collapse.

This week, we will post questions on Maternal Collapse. The link to the RCOG Guideline is – https://www-temp.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/maternal-collapse-in-pregnancy-and-the-puerperium-green-top-guideline-no-56/ The Link to the obgresource Summary on Maternal Collapse is- https://obgresource.com/topics/maternal-collapse/

Today’s Quiz

A woman at 11 weeks gestation presents with Hyperemesis Gravidarum. Which intravenous fluid should be the started at first ?
A. Lactated Ringer

B. Sodium Chloride 0.9% with Potassium

C. Dextrose 5%

WHO Semen Parameters

The WHO Reference Limits are as follows- ( the 95%Confidence Intervals are mentioned in the free access TOG article) Semen volume (ml) 1.5 Sperm concentration (106/ml) 15.0 Total number (106/ejaculate) 39.0 Total motility (PR+NP, %) 40.0 PR (%) 32.0 Normal forms (%) 4.0 Vitality (%) […]

Today’s Quiz

10 Years ago- On 4 July 2012 the Higgs Boson was discovered. Today is the Anniversary of the discovery of the Higgs boson. Galarza Creador, CC BY 4.0, via Wikimedia Commons

Next Week’s Topic

Next week, we are going to ask questions on two of the most causes of vaginal discharge- Vulvovaginal Candidiasis and Bacterial Vaginosis. CLICK HERE TO READ THE BASHH GUIDELINE ON VVC- https://www.bashhguidelines.org/current-guidelines/vaginal-discharge/vulvovaginal-candidiasis-2019/ CLICK HERE TO READ THE BASHH GUIDELINE ON BV– https://www.bashhguidelines.org/current-guidelines/vaginal-discharge/bacterial-vaginosis-2012/

Next Week’s Topic

Next week we are going to post questions on a difficult infection- Syphilis. What is the origin of the word Syphilis? A. It has been derived from a Latin word meaning ‘Ulcer’B. It the Old Time English word for ‘Horrible’C. From the name of the […]

Today’s Quiz 27/4/22

Note- We are aware of a software issue with the website login, and the fact that several of our users were locked out of the website. The issues has been resolved, and users can now login freely. We sincerely apologize for the inconvenience.

Next Week’s Topic

Next Week’s Quiz Questions will be on ‘Ovarian Cysts’. The Links to the relevant Guidelines are below- 1. Management of Suspected Ovarian Masses in Premenopausal Women (Green-top Guideline No. 62)2. Ovarian Cysts in Postmenopausal Women (Green-top Guideline No. 34)

Answer to Today’s Quiz 18/4/22

1. 75 to 80% of Complete molar pregnancies usually arise as a consequence of duplication of a single sperm followingfertilisation of an ‘empty’ ovum. Some complete moles (20–25%) can arise after dispermic fertilisation of an ‘empty’ovum.2. Partial molar pregnancies are usually (90%) triploid in origin, […]

Today’s Quiz 3/4/22

A woman with epilepsy (WWE) on polytherapy is planning to get pregnant. If you had the option of stopping ONE of her medicines, which of the following medicines would you like to stop?

A. Lamotrigine

B. Sodium Valproate

C. Carbamazepine

D. Topiramate

Next Week’s Topic

Next Week’s Quiz Questions will be on – Hereditary Gynecologic Cancer SyndromesThe links to the relevant articles are- FREE ACCESS TOG ARTICLE ON LYNCH SYNDROME SCIENTIFIC IMPACT PAPER No 48 SCIENTIFIC IMPACT PAPER No. 66

Next week’s Topic

Next Week’s Quiz Questions will be on ‘Twin and Triplet Pregnancy’. The link to the NICE Guideline is – https://www.nice.org.uk/guidance/ng137/resources/twin-and-triplet-pregnancy-pdf-66141724389829

Today’s Quiz 25/1/22

A 34 weeks pregnant lady comes to the Maternity Unit at 11 PM. She complains of reduced fetal movements. This is the first time she has had reduced fetal movement. Her pregnancy has been low risk and a follow up with the midwife 1 day […]

Today’s Quiz 22/1/22

A 49 years old lady underwent vaginal hysterectomy for central prolapse.  The patient is not sexually active. At the end of the surgery, the vault is seen to descend to the introitus. What can be done to reduce the risk of post hysterectomy vaginal vault […]

Next Week’s Topic

Next week’s questions will be on Uterovaginal prolapse. The link to the relevant NICE and RCOG guidelines are below- RCOG Guideline on Post hysterectomy Vaginal Vault Prolapse- CLICK HERENICE Guidance- CLICK HERE

Today’s Quiz 3/1/2022

A woman presents at 18 weeks pregnancy for ultrasound scan.  On ultrasound, the placenta is 1 cm from internal os. What is the diagnosis? A. Placenta praevia B. Low lying placenta C. Placenta previa type 2 D. Diagnosis will be decided at 28 week ultrasound […]

Today’s Quiz 28/12/2021

A woman is diagnosed with calf vein DVT during pregnancy at 26 weeks pregnancy. How long should she receive treatment with LMWH?A. Toll 36 weeks B. Throughout pregnancy and should continue at least till 6 weeks postpartum.C. For 3 months from the start of treatmentD. […]

Today’s Quiz 27/12/2021

What is the recommendation regarding commencing treatment with LMWH (Low Molecular Weight Heparin) in a Pregnant lady presenting with Suspected DVT or Pulmonary Embolism?A. Treatment should be commenced in Suspected PE, But not in suspected DVT before confirmation.B. In both the conditions, Treatment should be […]

Today’s Quiz 25/12/2021

Select the contraindications/Cautions to use of Low molecular weight heparin- A. Platelet count < 75 × 10^9/l B. Platelet count < 50 × 10^9/l C. Acute haemorrhagic stroke in previous 4 weeks D. Acute ischaemic stroke in previous 4 weeks E. Severe Renal disease F. […]

Today’s Quiz

For how long after spinal anesthesia LMWH ( Low Molecular Weight Heparin) should be avoided ? ( Provided, of course ,  that there is no ongoing bleeding)  A. 4 hours B. 6 hours C. 8 hours D. 12 hours

Today’s Quiz 23/12/2021

For women who are on lifelong oral anticoagulation, when should LMWH be converted back to warfarin in the postpartum period ? ( Provided, of course , that there is no ongoing risk of haemorrhage) A. 72 hours postpartumB. 5-7 days postpartumC. 10 days postpartumD. 6 […]

Today’s Quiz 21/12/2021

Q3 VTE Prevention A pregnant woman is on long term oral anticoagulation due to previous history of pulmonary embolism. She reports to the maternity triage in early labor. She plans to get epidural analgesia. What is the recommended thromboprophylaxis in peripartum period for women with […]

Today’s Quiz 20/12/2021

A woman with history of deep vein thrombosis is on prophylactic dose of  Low molecular weight heparin( LMWH) . At 38 week’s gestation, she is planned for elective Lower Segment Cesarean section under Spinal Anesthesia. The LSCS is scheduled for 7 AM tomorrow morning. When […]

Today’s Quiz 19/12/2021

A 30 years old primigravida reports to the Booking Clinic. She had Deep vein thrombosis 2 years ago, and received anticoagulation for 6 months afterwards. She has no other medical conditions. There is no history of any major surgery. Her BMI is 24. Will she need thromboprophylaxis […]

Today’s Quiz 17/12/2021

What is the appropriate first line Surgical Intervention in Atonic Postpartum Haemorrhage ( PPH) , if pharmacologic therapy fails to control the haemorrhage? A. B Lynch SutureB. Stepwise devascularizationC. Intrauterine balloon tamponadeD. Uterine artery embolization

Today’s Quiz 16/12/2021

The RCOG guideline recommends the use of intravenous oxytocin to reduce the risk of PPH at the time of Caesarean Section. In women at increased risk of PPH, what else should be used to reduce the risk of bleeding?A. Intramuscular ErgometrineB. Intramuscular OxytocinC. Intramuscular CarbetocinD. […]

Today’s Quiz 14/12/2021

According to RCOG, in case of major PPH, what is the criteria for initiating transfusion of red blood cells?A. Ongoing bleeding and Hemoglobin of 7 gram/dLB. Any Hemoglobin of 8 gram/dL or lessC. Transfusion of red blood cells should not be initiated until blood loss […]

Today’s Quiz 13/12/2021

What is the recommendation for fluid therapy ( Crystalloid and colloid) in management of major PPH?

A. Up to 2 liter isotonic crystalloid and Up to 1.5 liter colloid until blood arrives.

B.Up to 2 liter isotonic crystalloid and Up to 2 liter colloid until blood arrives.

C. Up to 1 liter fast isotonic crystalloid and Up to 1 liter colloid until blood arrives.

D. Up to 1 liter isotonic crystalloid and Up to 500mL colloid.

Today’s Quiz- 12/12/2021

Treatment of antenatal anemia may reduce the morbidity associated with PPH. What is the normal UK Range for Haemoglobin in pregnancy  ? A. 11 g/ 100 ml at first contact and 10.5 g/100 ml at 28 weeks.B. 12 g/ 100 ml at first contact and […]

Today’s Quiz 11/12/2021

A 28 years old Gravida 2 para 1, at 35 weeks gestation is thinking of VBAC. You ask her the reason of her last Ceasarean Section. Which of the following indications for previous caesarean section is associated with the highest chance of successful VBAC ?A. […]

Today’s Quiz 5/12/2021

Which of the following would be absolute contraindications for offering Vaginal birth after a previous 1 caesarean section( Check all that apply)

A. Previous Classical Caesarean Section

B. Previous Uterine Rupture

C. Previous 1 Lower Segment Caesarean Section with no history of any vaginal delivery

D. Previous 2 Lower Segment Caesarean Sections

Today’s Quiz 3/12/2021

According to the Cochrane database, of the following pain relief options in labor, which have been found to be effective  ?

A. Trancutaneous electrical nerve stimulation
B. Combined spinal + epidural analgesia
C. Acupuncture/Acupressure
D. Continuous one to one support
E. Epidural analgesia

Today’s Quiz 1/12/2021

When epidural analgesia is given for intrapartum analgesia, what are the observations/ precautions to be taken? ( Select all that apply)
A. Continuous electronic fetal monitoring after epidural analgesia

B. Continuous electronic fetal monitoring for 30 minutes during establishment or after boluses of 10 ml or more

C. Check blood pressure every 5 minutes for 15 minutes during establishment or after further boluses

D. Give loading dose of fluid before establishing epidural analgesia

Today’s Quiz 30/11/2021

A 38 years old chronic smoker lady is in labor. Which of the following modes of analgesia would not be preferred for the patient? A. Epidural analgesia B. Combined Spinal + Epidural analgesia C. Remifentanyl Patient controlled analgesia D. Nitrous Oxide

Next Week’s Topic

Next Week’s Quiz Questions will be on ‘Antenatal and Postnatal Analgesia’ Link to the Scientific Impact Paper No 59 from RCOG- https://www.rcog.org.uk/en/guidelines-research-services/guidelines/sip59/ There is a TOG article also on the subject- Alleemudder DI, Kuponiyi Y, Kuponiyi C, McGlennan A, Fountain S, Kasivisvanathan R. Analgesia for […]

Today’s Quiz 22/11/2021

How should women presenting with a breast lump during pregnancy be managed?

A. Referral to Breast Specialist

B. Ultrasound Breast

C. Fine Needle aspiration Cytology

D. Mammography should be done for initial evaluation o

Today’s Quiz 19/11/2021

Instrumental delivery associated with highest risk for obstetric anal sphincter injury A. Forceps delivery without episiotomy B. Forceps delivery with episiotomy C. Ventouse delivery without episiotomy D. Ventouse delivery with episiotomy

Today’s Quiz

According to the RCOG, at what amount of PPH and ongoing haemorrhage should a  Consultant Obstetrician attend a case of PPH? Any PPH Any ongoing PPH 1000 mL or more Any ongoing PPH 1500 mL or more Any ongoing PPH 2000 mL or more

Today’s Quiz

Which interventions have been shown to reduce the risk of PPH ( Check all that apply) A. Uterine massageB. Prophylactic uterotonicsC. For women delivering by caesarean section, oxytocin 5 iu by slow intravenous injection.D. For women delivering by caesarean section, oxytocin 10 iu by slow […]

Today’s Quiz 10/11/2021

What is the definition of Prolonged Third Stage of Labor ? 1.Duration more than 60 minutes 2. Duration more than 30 minutes 3. Duration more than 30 minutes if active management is being done 4. Duration more than 60 minutes if physiological management is being […]

Today’s Quiz 9/11/2021

Which Pharmacological agent is recommended by NICE in Active Management of Third Stage of Labor ? A. Oxytocin 10 IU intramuscular B. Oxytocin 5 IU Intravenous C. Ergometrine 0.5 mg intramuscular D. Syntometrine ( Oxytocin+ Ergometrine)

Today’s Quiz 08/11/2021

Check all that apply to physiological Management of Third Stage of labor- A. . It is associated with nausea and vomiting in about 50 in 1,000 women B. It is associated with an approximate risk of 29 in 1,000 of a haemorrhage of more than […]

Today’s Quiz 5/11/2021

How frequently should Anti D titres be measured in an alloimmunized woman ? A. Every 4 weeks till 28 weeks, then every week till 36 weeks B. Every 4 weeks till 28 weeks, then every 2 weeks till delivery C. Every 4 weeks till 32 […]

Today’s Quiz 2/11/2021

A pregnant lady at 10 weeks pregnancy is found to have Anti D Red cell antibodies. She has separated from her partner and his blood group cannot be found out. What other test can be offered earliest to her to check if the fetus is […]

Today’s Quiz

What is the recommended frequency of testing for Blood Group and Red Cell antibodies(Type and Screen) in Pregnancy ? A. Booking visit or first encounter in pregnancy B. Booking, 20 weeks, 32 weeks C. Booking and 28 weeks D. Booking and 32 weeks

Today’s Quiz

You are performing an abdominal myomectomy for a para 3 for fibroid uterus. After opening the abdomen, you find that there is a tubal ectopic pregnancy . The staff nurse tells you that the patient’s urine pregnancy test is positive and by mistake, this fact […]

Today’s Quiz 27/10/2021

A patient with transverse lie at 38 weeks pregnancy is seen in the clinic. She does not speak English. Her relative comes to help in translation and informs you that the patient does not agree for Caesarean section. Which of the following is true( In […]

Next Week’s Topic

Next week’s Quiz Questions will be on ‘Consent ‘ Links to the relevant resources- Obtaining Valid Consent( RCOG Clinical Governance Advice No 6) RCOG Procedure Specific Consent Advice

Features of CTG

Reassuring Non Reassuring Abnormal BASELINE ( bpm) 110 TO 160 100 to 109161 to 180 Less than 100More than 180 VARIABILITY ( bpm) 5 to 25 Less than 5 for 30 to 50 minOR More than 25 for 15 to 25 minutes – Less than […]