clinical ob Interview Questions and Answers

1. What is the difference between gravida and para?

   • Answer: Gravida refers to the number of times a woman has been pregnant, regardless of the outcome. Para refers to the number of pregnancies that have reached viability (usually 20 weeks gestation), regardless of whether the fetus was born alive or stillborn.

2. Explain the Naegele's rule for calculating the estimated due date (EDD).

   • Answer: Naegele's rule is: First day of last menstrual period (LMP) - 3 months + 7 days. It's an estimate, and ultrasound is often used for more accurate dating.

3. Describe the stages of labor.

   • Answer: Labor is divided into three stages: First stage (cervical dilation and effacement), second stage (delivery of the baby), and third stage (delivery of the placenta).

4. What are the cardinal movements of labor?

   • Answer: Engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.

5. What is the significance of fetal heart rate monitoring?

   • Answer: Fetal heart rate monitoring assesses fetal well-being during labor and identifies potential signs of fetal distress, such as hypoxia.

6. Explain the different types of fetal presentations.

   • Answer: Cephalic (head first), breech (buttocks or feet first), shoulder (shoulder first).

7. What is the significance of amniotic fluid?

   • Answer: Amniotic fluid cushions the fetus, protects against infection, and allows for fetal lung development.

8. What are the signs and symptoms of preeclampsia?

   • Answer: Hypertension, proteinuria, edema, headache, visual disturbances.

9. What is eclampsia?

   • Answer: Eclampsia is the development of seizures in a woman with preeclampsia.

10. What are the risk factors for gestational diabetes?

    • Answer: Obesity, family history of diabetes, previous history of gestational diabetes, advanced maternal age.

11. Explain postpartum hemorrhage (PPH).

    • Answer: PPH is defined as blood loss exceeding 500ml after vaginal delivery or 1000ml after cesarean delivery.

12. What are the causes of postpartum hemorrhage?

    • Answer: Uterine atony, retained placenta, lacerations, coagulation disorders.

13. Describe postpartum blues versus postpartum depression.

    • Answer: Postpartum blues are transient mood swings, while postpartum depression is a more severe and persistent mood disorder.

14. What is the purpose of RhoGAM?

    • Answer: RhoGAM prevents the development of antibodies in Rh-negative mothers who have been exposed to Rh-positive fetal blood, preventing hemolytic disease of the newborn.

15. Explain the different types of episiotomies.

    • Answer: Midline and mediolateral.

16. What are the signs of placental abruption?

    • Answer: Vaginal bleeding, abdominal pain, fetal distress.

17. What is placenta previa?

    • Answer: Placenta previa is when the placenta implants low in the uterus, partially or completely covering the cervix.

18. What are the risk factors for preterm labor?

    • Answer: Infections, multiple gestation, previous preterm delivery, smoking, substance abuse.

19. What is the role of a certified nurse midwife (CNM)?

    • Answer: CNMs provide comprehensive care to women throughout pregnancy, labor, delivery, and postpartum.

20. What is the significance of Apgar scores?

    • Answer: Apgar scores assess the newborn's physical condition at 1 and 5 minutes after birth.

21. Explain the difference between a vaginal birth after cesarean (VBAC) and a repeat cesarean.

    • Answer: VBAC is attempting a vaginal birth after a previous cesarean, while a repeat cesarean involves having another cesarean birth.

22. What is the purpose of cervical ripening?

    • Answer: Cervical ripening methods are used to soften and dilate the cervix to help induce labor.

23. What are some methods of inducing labor?

    • Answer: Membrane stripping, Pitocin (oxytocin), prostaglandins.

24. What are the signs of uterine rupture?

    • Answer: Sudden, severe abdominal pain, cessation of contractions, fetal bradycardia, vaginal bleeding, signs of maternal shock.

25. What is the management of shoulder dystocia?

    • Answer: McRoberts maneuver, suprapubic pressure, delivery of posterior shoulder.

26. What is the purpose of postpartum checkups?

    • Answer: To monitor the mother's physical and emotional recovery, and to address any concerns or complications.

27. What is a prolapsed umbilical cord?

    • Answer: A prolapsed umbilical cord occurs when the umbilical cord descends into the vagina or cervix before the baby.

28. How is a prolapsed umbilical cord managed?

    • Answer: Manual elevation of the cord, positioning the mother, immediate cesarean delivery.

29. What is the significance of fundal height measurement?

    • Answer: Fundal height measurement assesses fetal growth and gestational age.

30. What is the difference between a nuchal cord and a cord around the neck?

    • Answer: They are the same thing; the umbilical cord is wrapped around the fetal neck.

31. What are the signs and symptoms of postpartum infection?

    • Answer: Fever, chills, uterine tenderness, foul-smelling lochia.

32. What is mastitis?

    • Answer: Mastitis is inflammation of the breast tissue, often associated with breastfeeding.

33. What is a fetal non-stress test (NST)?

    • Answer: An NST monitors fetal heart rate in relation to fetal movement.

34. What is a biophysical profile (BPP)?

    • Answer: A BPP assesses fetal well-being by evaluating fetal heart rate, breathing movements, body movements, muscle tone, and amniotic fluid volume.

35. What is a contraction stress test (CST)?

    • Answer: A CST evaluates fetal heart rate response to uterine contractions to assess fetal oxygenation.

36. What are the different types of breech presentations?

    • Answer: Frank breech, complete breech, footling breech.

37. What is the management of a breech presentation?

    • Answer: External cephalic version (ECV) may be attempted, otherwise, cesarean delivery is typically recommended.

38. What is a cervical cerclage?

    • Answer: A surgical procedure to reinforce the cervix and prevent premature dilation and delivery.

39. What is the role of tocolytics in preterm labor?

    • Answer: Tocolytics are medications used to suppress uterine contractions and delay delivery in preterm labor.

40. What are some examples of tocolytic medications?

    • Answer: Magnesium sulfate, terbutaline, indomethacin.

41. What is the significance of fetal fibronectin (fFN) testing?

    • Answer: fFN testing helps predict the risk of preterm delivery.

42. What is postpartum psychosis?

    • Answer: A severe mental illness that can occur in the postpartum period, characterized by hallucinations, delusions, and disorganized thinking.

43. What is the management of postpartum psychosis?

    • Answer: Hospitalization, medication, supportive therapy.

44. What is HELLP syndrome?

    • Answer: HELLP syndrome is a severe form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count.

45. What is the management of HELLP syndrome?

    • Answer: Immediate delivery of the baby, supportive care.

46. What is gestational hypertension?

    • Answer: Development of hypertension (high blood pressure) after 20 weeks of pregnancy without proteinuria.

47. What are the risk factors for postpartum depression?

    • Answer: History of depression, anxiety, or other mental health disorders; difficult pregnancy or delivery; lack of social support; stressful life events.

48. What is the difference between true labor and false labor?

    • Answer: True labor involves regular, increasingly frequent, and stronger contractions that cause cervical change. False labor involves irregular contractions that don't cause cervical change.

49. What is the role of antibiotics in preventing Group B Streptococcus (GBS) infection in newborns?

    • Answer: Intrapartum antibiotics are given to mothers who screen positive for GBS to prevent transmission to the newborn.

50. What is the significance of monitoring fetal movement?

    • Answer: Monitoring fetal movement helps assess fetal well-being. Decreased fetal movement can be a sign of fetal distress.

51. What is a vacuum-assisted delivery?

    • Answer: A vacuum-assisted delivery uses a suction cup to assist in the delivery of the baby.

52. What is a forceps-assisted delivery?

    • Answer: A forceps-assisted delivery uses forceps to assist in the delivery of the baby.

53. What are the potential complications associated with vacuum-assisted and forceps-assisted deliveries?

    • Answer: Cephalohematoma, scalp lacerations, facial nerve palsy for both. Also, maternal vaginal or cervical lacerations.

54. What is the importance of postpartum education?

    • Answer: Postpartum education empowers mothers to care for themselves and their newborns, promoting successful breastfeeding, postpartum recovery, and early identification of potential problems.

55. What is the difference between oligohydramnios and polyhydramnios?

    • Answer: Oligohydramnios is decreased amniotic fluid, while polyhydramnios is excessive amniotic fluid.

56. What are the potential causes of oligohydramnios?

    • Answer: Renal agenesis, placental insufficiency, premature rupture of membranes.

57. What are the potential causes of polyhydramnios?

    • Answer: Gestational diabetes, fetal anomalies, multiple gestation.

58. What is the role of a doula?

    • Answer: A doula provides emotional, physical, and informational support to women during pregnancy, labor, and postpartum.

59. What is postpartum bonding?

    • Answer: The process of developing a close emotional connection between the parent(s) and their newborn.

60. How do you manage a woman experiencing a prolapse of the umbilical cord?

    • Answer: Immediate medical attention is required. This involves elevating the presenting part of the fetus off the cord to alleviate pressure, administering oxygen to the mother, and preparing for an immediate cesarean section.

61. Explain the importance of assessing lochia postpartum.

    • Answer: Assessing lochia (postpartum vaginal discharge) helps to monitor the involution of the uterus and detect potential complications like infection or retained placental fragments. Changes in color, amount, or odor can indicate problems.

62. Describe the different types of lochia.

    • Answer: Lochia rubra (red), lochia serosa (pinkish-brown), lochia alba (white or yellowish).

63. What is the significance of assessing the fundus postpartum?

    • Answer: Assessing the fundus (top of the uterus) postpartum helps to monitor uterine involution and identify potential complications such as uterine atony, which can lead to postpartum hemorrhage.

64. What are some common breastfeeding challenges and how are they managed?

    • Answer: Latch difficulties (positioning and latch techniques), milk supply concerns (frequent feeding, skin-to-skin contact, lactation consultant), sore nipples (proper latch, lanolin cream), mastitis (antibiotics, frequent emptying of breasts). Lactation consultants can provide valuable support.

65. How would you counsel a patient about the risks and benefits of VBAC?

    • Answer: Discuss the potential benefits (avoiding a repeat cesarean), but also emphasize the risks, such as uterine rupture. Careful assessment of the patient's history and current condition is crucial to determining suitability for a VBAC attempt.

66. What are some strategies to prevent postpartum hemorrhage?

    • Answer: Fundal massage, early administration of uterotonics (such as oxytocin), ensuring complete placental delivery, monitoring for signs of bleeding.

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