Test your knowledge – EBCOG Examination

The EBCOG Examination assesses the knowledge gained by the candidates during their training in general Obstetrics and Gynaecology. The assessment is extended to the application of this knowledge to clinical cases and is based on the EBCOG training syllabus.

Would you like to test your knowledge and see examples of exam questions?

ANTENATAL OBSTETRIC PROBLEMS – vaginal bleeding

Options

a. Placental abruption

b. Pre-term labour

c. Vasa Praevia

d. Cervical Cancer

e. Inevitable miscarriage

f. Fetomaternal Haemorrhage

g. Placenta accreta

h. Placenta praevia

i. Benign cervical polyp

j. Pyelonephritis

For each scenario described below, choose the most likely answer from the above list of options. Each option may be used once, more than once or not at all.

1. A 40-year old woman in her first pregnancy with an IVF-induced twin pregnancy presents with a heavypainless vaginal bleeding at 32 weeks’ gestation. On examination both twins are in the transverseposition. On examination, mild uterine contractions, two in 10 minutes, lasting for 10 seconds arenoted.. Cardio- Topographic (CTG) tracings of both foetuses shows a reactive pattern.

2. A 25-year old woman in her second pregnancy has a painless non-substantial antepartumhaemorrhage at 20 weeks’ gestation. Abdominal examination shows a uterus corresponding to dates.Foetal heart was audible. On speculum examination, a 2cm friable mass is seen on her cervix.

3. A 35-year-old woman in her second pregnancy presents at 30 weeks’ gestation with moderate vaginalbleeding. She suffers from diabetic nephropathy and chronic hypertension that has been poorlycontrolled in the previous month. Her CTG demonstrates a sinusoidal pattern with Type 2 [Late]decelerations. On examination, there is marked uterine tenderness on the left side of the uterus. Thefoetus is in the breech position.

(Answers: 1 – H; 2 – D; 3 – A)

INTRAPARTUM OBSTETRIC PROBLEMS

Options

a. Episiotomy

b. Ventouse delivery

c. Foetal blood Sampling

d. Caesarean section

e. Offer Epidural analgesia

f. Allow her to establish in spontaneous labour

g. Commence oxytocin

h. Artificial rupture of membranes

i. Prostaglandin administration

j. Antibiotic administration

For each scenario described below, choose the most likely answer from the above list of options. Each option may be used once, more than once or not at all.

1. A 30-year-old woman with Type 1 Diabetes Mellitus (T1DM) in her third pregnancy undergoesinduction of labour with vaginal prostaglandin at 39 weeks gestation for poor metabolic control. Twohours later the cervix was found to be 4 cm dilated and fully effaced and fetal presentation cephalic with4/5ths of the head palpable suprapubically. Membranes were ruptured then causing an increase in thestrength and rate of uterine contractions [one every three minutes and lasting 60 seconds]. Review fourhours later showed the cervix to be 8 cm dilated and the presenting part at Station 0-2 and three hourslater the cervix to have remained at 8 cm with head 2/5ths palpable. The CTG shows repeatedaccelerations with every contraction.

2. A 28-year old in her first pregnancy is admitted at 41 weeks’ gestation after reporting spontaneousrupture of membranes at home 24 hours previously. On examination, uterine size corresponds to datesand foetal presentation is cephalic with 2/5ths of the head palpable suprapubically. Contractions areregular occurring at a rate of one every 10 minutes and each lasting for 20 seconds.

3. An 18-year old woman in her first pregnancy at 42 weeks is admitted with strong uterine contractionsoccurring once every four minutes lasting for 60 seconds. On examination, the fetal presentation iscephalic with four-fifths of the head palpable suprapubically. Vaginal examination shows a cervicaldilatation of 2 cm, 80% effacement, and station a 0-3 above the ischial spine. Clear liquor is draining. ACTG shows a reactive pattern with acceleration corresponding to the contractions. The woman is ratheranxious and reacts poorly to the contractions.

(Answers: 1 – D; 2 – G; 3 – E)