ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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EARLY FGR SUMMARY

 Early FGR: What You Need to Know


🩺 Focused History and Examination



Take a detailed history and conduct a thorough examination.


If the physiological height is less than the 10th centile or there’s no growth for over 2 weeks, suspect SGR/FGR.

🔬 Investigations


Focus on weight/biometry:


Less than 3rd centile or less than 10th centile with:


🔴 Abnormal umbilical artery Doppler, or


🔴 Abnormal uterine artery Doppler.

💡 Diagnosis: Early FGR.


🛠 Management Plan


🤝 Support and Counseling


Counsel the patient regarding:


The diagnosis of Early FGR.


Associated fetal and maternal risks.

Involve the Multidisciplinary Team (MDT) and ensure follow-ups at a consultant-led unit.

🧑‍⚕️ Maternal Assessment


At every visit, check for:


📊 Blood pressure.


🧪 Protein in urine.


💭 Fetal movements (ask the mother).

👶 Fetal Assessment


Regular evaluations include:


📏 Growth biometry scans.


🌊 Umbilical artery Doppler.


Additional tests:


📈 cCTG (Cardiotocography).

🩸 Ductus venosus Doppler.

📅 Frequency of Monitoring

weekly: Umbilical Doppler

Umbilical artery doppler  on Alternate days: If umbilical changes are borderline.

Daily ductus venosus doppler or cCTG : If critical umbilical Doppler changes due to sudden deterioration risks.

🚨 Delivery Plan in Early FGR


1. By 26 Weeks: Deliver if persistent UNPROVKED fetal heart rate decelerations occur.

2. 26–28+6 Weeks: Deliver if:

📉 Ductus venosus A wave at/below baseline.

STV <2.6 ms.

3. 29–31+6 Weeks: Deliver if:


A wave abnormality persists.


STV <3 ms.


4. 32–33+6 Weeks: Deliver if:


cCTG = STV <3.5 ms.


Reversed umbilical artery flow.


Consider after 30 weeks if abnormalities persist.

5. 34–36+6 Weeks (Consider after 32 weeks):


Deliver if STV <4.5 ms or UA= absent end-diastolic flow.

6. 36–36+6 Weeks: Deliver if umbilical pulsatility index >95th percentile.

🩺 Maternal Concerns and Monitoring

Deliver earlier if:

🚩 Maternal concerns arise.

🚩 Decreased fetal movements are reported.

Perform 📹 ultrasound for confirmation.

If abnormalities persist, proceed to computerized CTG.

🔄 General Monitoring

If umbilical Doppler abnormalities are detected:

Check for pulsations.

If present, conduct ductus venosus Doppler.

remember Administer:

💉 Steroids for fetal lung maturity.

💊 Magnesium sulfate for neuroprotection.

Delivery method: Emergency C-section.

After delivery tests like apla 

🌈 Next Pregnancy: Preventative Measures

1.Early Booking

Plan early and classify as high risk.

2. Preventative Measures

🏥 Aspirin (150 mg daily): Start before 16 weeks.

🌊 Uterine artery Doppler at the anomaly scan.

📅 Serial growth ultrasounds from the second trimester.

3. Modifiable Risk Factors

🚭 Stop smoking.

🚫 Avoid alcohol and drugs.

💊 Control hypertension, diabetes, and other conditions.

🥗 Maintain a balanced diet and take supplements.


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ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

Image
  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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