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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SGA ; SUMMARY ; Investigation and Care of a Small-for-Gestational-Age Fetus and aGrowth Restricted Fetus (Green-top Guideline No. 31)

  Initial Steps: History and Examination 🩺



Take a focused history to identify any risk factors for SGA.

Examine the abdomen:

Check the symphysis-fundal height:

If less than the 10th centile, OR

Serial measurements over 2 weeks show no growth ➡️ proceed to investigations.

Investigations 🔍

Ultrasound scan to assess:

Fetal weight and abdominal circumference (biometry).

If:

Measurements are <10th centile but >3rd centile, AND

Criteria for fetal growth restriction (FGR) are not met, classify as SGA.


MANAGEMENT 

  •  Counseling and Support 🤝
  • Counsel the patient on:
  • The condition and its implications.
  • The need for regular antenatal follow-ups.
  • Involve the MDT (Multidisciplinary Team) for comprehensive care.

Maternal Monitoring 🤰

At every antenatal visit:Monitor blood pressure and Check for protein in urine to rule out preeclampsia.

Ask about fetal movements : Fetal Monitoring 👶

Perform fetal surveillance every 2 weeks: Biometry to monitor growth nd Umbilical artery Doppler.

Fetal heart rate monitoring by ultrasound ot ctg if clinically indicated.

Management and Delivery Decisions 🏥

If there are no concerns:

Continue pregnancy until 39 weeks.

Offer induction of labor at 39 weeks while counseling the patient of the risks of abnormal heart rate and thus emergency C-section.

If there are concerns after 37 weeks: Check additional markers:

  • Middle cerebral artery Doppler (MCA).
  • Cerebro-placental ratio (CPR).
  • Umbilical-cerebral ratio.

If Doppler results are abnormal, consider early delivery.

Do not prolong pregnancy beyond 39+6 weeks, as these  Doppler findings cannot ensure fetal reassurance.

In next preg risk of late iugr so anomaly scan nd weight of baby then  serial scan from 32 weeks 

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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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