Question Easy:
A 28-year-old primigravida presents at 20 weeks of gestation for a routine scan. She is curious about her baby’s movements and asks when she might start to feel them. What is the typical gestational age for primigravidas to first notice fetal movements? 🌟
A) 12-14 weeks
B) 16-18 weeks
C) 18-20 weeks
D) 20-22 weeks
E) 22-24 weeks
Question Medium:
A 32-year-old woman presents with heavy menstrual bleeding and a pelvic ultrasound shows fibroids. She is keen to preserve her fertility. Which of the following management options is most appropriate initially?
A) Hysterectomy
B) Endometrial ablation
C) Mirena (levonorgestrel-releasing intrauterine system)
D) GnRH analogues
E) Myomectomy
Question Hard:
A 24-year-old woman presents at 32 weeks of gestation with abdominal pain and vaginal bleeding. She has had no antenatal complications until now. On examination, her uterus is tender and her fundal height is consistent with dates. Her observations are stable, but the fetal heart rate is concerning for distress. What is the most likely diagnosis? 🤔
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Vasa previa
E) Preterm labour
Explanations & Answers:
Question Easy Answer: C) 18-20 weeks
Question Easy Explanation: Primigravid women typically start feeling fetal movements around 18-20 weeks of gestation. These movements, also known as “quickening,” might be felt earlier (around 16-18 weeks) by multigravidas. Recognizing these movements can provide reassurance to the mother about fetal well-being.
Question Medium Answer: C) Mirena (levonorgestrel-releasing intrauterine system)
Question Medium Explanation: For women with uterine fibroids who experience heavy menstrual bleeding and want to preserve fertility, the levonorgestrel-releasing intrauterine system (LNG-IUS) is often recommended as an initial treatment. According to NICE guidelines, it is less invasive, offers good control of menorrhagia, and preserves fertility.
Question Hard Answer: B) Placental abruption
Question Hard Explanation: In this case, the symptoms of abdominal pain, vaginal bleeding, and a tender uterus at 32 weeks suggest placental abruption. This condition involves premature separation of the placenta and can lead to fetal distress or maternal complications if not managed promptly. Timely diagnosis and management are crucial to ensure favourable outcomes for both mother and baby.
Medical fact of the day: Did you know that the average placenta weighs about 500-600 grams by full term? It’s a vital organ that forms during pregnancy to provide oxygen and nutrients to the developing fetus while removing waste products. 🌱
Quote of the day: “In the heart of care lies the art of listening, for every patient carries a story waiting to unfold.” 🌈