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Exam pass rate: Merit-based; a maximum of 30 Ministry of Health places were offered in the February/April 2026 sitting.
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Key Facts: PGIM MD ObGyn Exam

50

MCQ paper questions

900

Total marks across three components

6

OSVE stations

Rs. 104k

Full fee (state sector)

The PGIM Selection Examination for MD in Obstetrics & Gynaecology is a 900-mark, three-component examination: a 50-question MCQ paper, a written paper of four structured essays and two short-answer questions, and a six-station Objective Structured Viva Examination. A pass needs 50% in each component and 50% in aggregate.

Sample PGIM MD ObGyn Practice Questions

Try these sample questions to review concepts for the PGIM MD ObGyn exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old primigravida at 24 weeks of gestation attends a routine antenatal clinic. Which of the following cardiovascular physiological adaptations is expected in normal pregnancy at this gestational age?
A.Significant increase in systemic vascular resistance with an elevated mean arterial pressure
B.Elevation in resting maternal cardiac output by approximately 30% to 50% above non-pregnant baseline
C.Marked decrease in maternal blood volume secondary to urinary sodium and water wasting
D.Reduction in maternal resting heart rate due to reflex vagal hypertonia
Explanation: During normal pregnancy, maternal cardiac output increases by 30% to 50% above baseline, peaking in the late second and early third trimesters. This rise is achieved through an increase in stroke volume (by 20-30%) and an increase in resting heart rate (by 15-20 bpm). Systemic vascular resistance drops significantly due to progesterone and local vasodilators like nitric oxide, maintaining normal or lower mean arterial blood pressure.
2A 24-year-old woman at 16 weeks of gestation undergoes routine antenatal renal biochemistry testing. Which finding represents an expected physiological change in renal parameters during normal pregnancy?
A.Serum creatinine concentration of 38-55 µmol/L (0.4-0.6 mg/dL)
B.Marked reduction in glomerular filtration rate (GFR) secondary to reduced renal plasma flow
C.Significant increase in serum uric acid above 450 µmol/L in early second trimester
D.Elevated serum blood urea nitrogen (BUN) exceeding 8.5 mmol/L
Explanation: Glomerular filtration rate (GFR) and renal plasma flow increase by 40% to 50% beginning in early pregnancy, leading to increased clearance of nitrogenous wastes. As a result, normal serum creatinine and blood urea nitrogen fall to roughly 35-55 µmol/L (0.4-0.6 mg/dL) and 2.5-4.5 mmol/L respectively. A non-pregnant 'normal' serum creatinine of 85 µmol/L (1.0 mg/dL) in pregnancy should raise suspicion of underlying renal impairment.
3A healthy pregnant woman at 28 weeks of gestation presents with mild physiological dyspnoea. An arterial blood gas (ABG) analysis is performed. What acid-base profile is considered physiological in healthy pregnancy?
A.Uncompensated metabolic acidosis with hypercapnia
B.Compensated respiratory alkalosis with PaCO2 around 28-32 mmHg and decreased serum bicarbonate
C.Severe respiratory acidosis with PaCO2 around 45-50 mmHg
D.Uncompensated metabolic alkalosis with elevated PaCO2
Explanation: High levels of progesterone stimulate the medullary respiratory centre directly, increasing tidal volume and minute ventilation by about 40-50%. This maternal hyperventilation blows off carbon dioxide, resulting in a physiological compensated respiratory alkalosis (PaCO2 typically 28-32 mmHg, arterial pH 7.40-7.45). The kidneys compensate by increasing bicarbonate excretion, dropping serum bicarbonate to roughly 18-22 mmol/L.
4During physiological placentation, extravillous trophoblasts invade the maternal decidua and myometrium. Which vascular transformation is essential to establish normal low-resistance uteroplacental blood flow?
A.Constriction and muscular hypertrophy of maternal radial arteries
B.Conversion of high-resistance muscular spiral arteries into high-flow, low-resistance dilated conduits devoid of elastic lamina
C.Endothelial proliferation that obliterates the lumen of maternal arcuate veins
D.Deposition of thick subendothelial fibrinoid cushions that occlude fetal cotyledonary capillaries
Explanation: Extravillous trophoblasts migrate down the maternal spiral arteries in two waves (first wave before 10 weeks, second wave at 14-18 weeks), replacing vascular smooth muscle and the internal elastic lamina with fibrinoid material. This converts narrow, tortuous, muscular spiral arteries into wide-bore, flaccid, low-resistance vessels unresponsive to vasoconstrictor stimuli. Failure of this physiological remodeling is the fundamental primary defect in pre-eclampsia and fetal growth restriction.
5A 31-year-old woman undergoes first-trimester combined screening for fetal aneuploidy at 12 weeks of gestation. Which combination of biochemical and ultrasound markers is characteristic of fetal Trisomy 21 (Down syndrome)?
A.Decreased nuchal translucency (NT), elevated maternal serum PAPP-A, and decreased free beta-hCG
B.Increased nuchal translucency (NT), decreased maternal serum PAPP-A, and increased free beta-hCG
C.Normal nuchal translucency (NT), markedly elevated PAPP-A, and undetectable free beta-hCG
D.Increased nuchal translucency (NT), elevated maternal serum PAPP-A, and decreased free beta-hCG
Explanation: The first-trimester combined test (performed between 11+0 and 13+6 weeks) assesses fetal nuchal translucency (NT), maternal serum pregnancy-associated plasma protein A (PAPP-A), and free beta-human chorionic gonadotropin (free beta-hCG). In Trisomy 21, fetal NT is increased, maternal serum free beta-hCG is significantly elevated (~2.0 MoM), and maternal serum PAPP-A is reduced (~0.5 MoM). In contrast, Trisomy 18 and 13 typically demonstrate low levels of both free beta-hCG and PAPP-A.
6An ultrasound scan performed at 12 weeks of gestation in a spontaneous twin pregnancy demonstrates two gestational sacs separated by a thick inter-twin membrane with a triangular projection of placental tissue extending into the base of the membrane. What is the chorionicity and amnionicity of this pregnancy?
A.Monochorionic diamniotic (MCDA)
B.Dichorionic diamniotic (DCDA)
C.Monochorionic monoamniotic (MCMA)
D.Dichorionic monoamniotic
Explanation: The ultrasound finding of the 'lambda sign' (also known as the 'twin peak' sign), representing an extension of chorionic villi between the two layers of amnion and chorion at the membrane base, is diagnostic of dichorionic diamniotic (DCDA) twins. In contrast, monochorionic diamniotic (MCDA) twins exhibit the 'T sign', where the thin inter-twin membrane meets the single placenta at a perpendicular 90-degree angle without intervening placental tissue. Dichorionic monoamniotic gestations are embryologically impossible.
7A 26-year-old RhD-negative primigravida has an unsensitised indirect Coombs test at booking. Which of the following tests is routinely indicated following delivery to quantify fetomaternal haemorrhage (FMH) and determine the required dose of anti-D immunoglobulin?
A.Maternal direct antiglobulin (Coombs) test
B.Kleihauer-Betke test or flow cytometry on maternal blood
C.Umbilical cord blood serum ferritin concentration
D.Maternal serum alpha-fetoprotein level
Explanation: The Kleihauer-Betke acid-elution test or maternal flow cytometry is performed following delivery of an RhD-positive infant to an RhD-negative mother to quantify the volume of fetomaternal haemorrhage (FMH). Standard postpartum anti-D immunoglobulin dosing (e.g., 500 IU or 1500 IU depending on national protocols) covers FMH up to a specified threshold (e.g., 4-15 mL fetal red cells); if FMH exceeds this threshold, additional anti-D immunoglobulin must be administered. The direct Coombs test on newborn cord blood checks for in vivo red cell coating, not FMH quantification.
8According to international consensus (e.g., Delphi criteria) and national obstetric guidelines, which sonographic parameter is the single most sensitive biometric indicator for diagnosing fetal growth restriction (FGR)?
A.Biparietal diameter (BPD)
B.Fetal abdominal circumference (AC) or estimated fetal weight (EFW) below the 10th centile
C.Femur length (FL) below the 50th centile
D.Nuchal fold thickness in the third trimester
Explanation: Fetal abdominal circumference (AC) reflects liver size and subcutaneous abdominal fat deposition, both of which are rapidly depleted in utero-placental insufficiency due to glycogen store mobilisation. Consequently, an AC or estimated fetal weight (EFW) below the 10th centile for gestational age (or below the 3rd centile for severe FGR) serves as the primary sonographic metric for identifying small-for-gestational-age and growth-restricted fetuses. BPD and FL are relatively preserved in asymmetrical growth restriction ('brain-sparing').
9A 30-year-old asymptomatic multigravida at 34 weeks of gestation has an incidental platelet count of 95 × 10^9/L on a routine complete blood count. Her blood pressure is 114/72 mmHg, urinalysis shows no proteinuria, liver enzymes are normal, and a peripheral blood smear shows normal red cell morphology. What is the most likely diagnosis?
A.Primary immune thrombocytopenia (ITP) requiring urgent corticosteroid therapy
B.Gestational thrombocytopenia
C.HELLP syndrome
D.Thrombotic thrombocytopenic purpura (TTP)
Explanation: Gestational thrombocytopenia accounts for over 75% of all cases of thrombocytopenia in pregnancy. It typically develops in the mid-to-late third trimester, is asymptomatic with no history of bleeding or pre-pregnancy thrombocytopenia, typically remains above 70-80 × 10^9/L, and spontaneously resolves within 6 to 12 weeks postpartum. It is not associated with adverse maternal or fetal outcomes, and invasive management or steroids are not required.
10Substances cross the human syncytiotrophoblast through diverse transport mechanisms. Which pair accurately matches the maternal-fetal nutrient or biomolecule with its primary mode of placental transfer?
A.Glucose — active transport against a steep concentration gradient requiring ATP
B.Immunoglobulin G (IgG) — receptor-mediated endocytosis via neonatal Fc receptors (FcRn)
C.Amino acids — simple passive lipophilic diffusion through lipid bilayers
D.Oxygen and carbon dioxide — secondary active co-transport mediated by sodium exchangers
Explanation: Maternal IgG antibodies are transferred across the syncytiotrophoblast via receptor-mediated endocytosis (transcytosis) utilising neonatal Fc receptors (FcRn), conferring passive humoral immunity to the fetus. Glucose crosses by facilitated diffusion down a concentration gradient mediated by glucose transporter proteins (principally GLUT-1). Amino acids are transported by active transport mechanisms (system A, system L) requiring ATP, resulting in higher fetal concentrations than maternal levels. Respiratory gases cross by simple passive diffusion.

About the PGIM MD ObGyn Exam

The Selection Examination for MD in Obstetrics & Gynaecology is conducted by the Postgraduate Institute of Medicine, University of Colombo, to select medical officers for the MD (Obstetrics & Gynaecology) training programme leading to board certification in Obstetrics and Gynaecology in Sri Lanka. It is set and sat in English under the 2017 prospectus and its amendments.

Exam sponsor: Postgraduate Institute of Medicine, University of Colombo. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Component 1 is a 2.5-hour MCQ paper of 50 questions (20 true/false, 30 single-best-answer). Candidates scoring 50% or more proceed to Component 2, a 3-hour written paper of four structured essay questions and two short-answer questions, and Component 3, a six-station Objective Structured Viva Examination of 10 minutes per station (plus 1 minute preparation), lasting 66 minutes. Each component carries 300 marks.

Time Limit

MCQ paper 2.5 hours; written paper 3 hours; OSVE 66 minutes across six stations.

Passing Score

50% or more in the MCQ paper is required to proceed. A pass requires 450 or more of 900 marks in aggregate and at least 150 of 300 in each of the MCQ paper, the written paper and the OSVE.

Exam / Certification Fees

Rs. 104,000 for state-sector candidates (Rs. 15,500 registration + Rs. 8,500 application + Rs. 80,000 examination fees); Rs. 58,500 is payable with the application and the Rs. 45,500 balance only after passing the MCQ paper. Non-state-sector candidates pay 50% more.

Exam sponsor website

Reported exam pass rate: Merit-based; a maximum of 30 Ministry of Health places were offered in the February/April 2026 sitting.. The PGIM publishes merit lists and pass index numbers per sitting rather than percentage pass rates. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

All three components

Maternal-Fetal Medicine

Maternal physiological adaptation, placentation, aneuploidy and anomaly screening, fetal growth restriction, Doppler surveillance, multiple pregnancy and alloimmunisation.

All three components

High-Risk Obstetrics & Labour Management

Hypertensive disorders and eclampsia, antepartum and postpartum haemorrhage, preterm labour and PPROM, intrapartum fetal monitoring, operative delivery and obstetric emergencies.

All three components

General Gynaecology & Reproductive Health

Abnormal uterine bleeding and PALM-COEIN, fibroids and adenomyosis, endometriosis, PCOS, subfertility and assisted reproduction, contraception and pelvic infection.

All three components

Gynaecological Oncology & Early Pregnancy

Cervical screening and pre-invasive disease, cervical, endometrial and ovarian cancer, gestational trophoblastic disease, miscarriage and ectopic pregnancy.

Preparing for the PGIM MD ObGyn Exam

What You Need to Know

  • Passing score: 50% or more in the MCQ paper is required to proceed. A pass requires 450 or more of 900 marks in aggregate and at least 150 of 300 in each of the MCQ paper, the written paper and the OSVE.
  • Assessment: Component 1 is a 2.5-hour MCQ paper of 50 questions (20 true/false, 30 single-best-answer). Candidates scoring 50% or more proceed to Component 2, a 3-hour written paper of four structured essay questions and two short-answer questions, and Component 3, a six-station Objective Structured Viva Examination of 10 minutes per station (plus 1 minute preparation), lasting 66 minutes. Each component carries 300 marks.
  • Time limit: MCQ paper 2.5 hours; written paper 3 hours; OSVE 66 minutes across six stations.
  • Exam / certification fees: Rs. 104,000 for state-sector candidates (Rs. 15,500 registration + Rs. 8,500 application + Rs. 80,000 examination fees); Rs. 58,500 is payable with the application and the Rs. 45,500 balance only after passing the MCQ paper. Non-state-sector candidates pay 50% more. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

PGIM MD ObGyn: Suggested Study Strategy

1Memorize the diagnostic criteria and management thresholds for hypertensive disorders of pregnancy, including the loading and maintenance doses of magnesium sulphate.
2Review the FIGO/NICE classification of intrapartum cardiotocography: baseline rate, variability, accelerations, and deceleration patterns.
3Understand the management sequence for major postpartum haemorrhage: uterotonics (oxytocin, ergometrine, carboprost, misoprostol), balloon tamponade, and surgical hemostasis.
4Review the FIGO staging systems for cervical, endometrial, and ovarian cancers.
5Focus on medical and surgical management options for ectopic pregnancy and early pregnancy loss.

Frequently Asked Questions

What is the examination structure of the PGIM MD ObGyn selection exam?

Three components: a 2.5-hour, 50-question MCQ paper; a 3-hour written paper of four structured essay questions and two short-answer questions; and a six-station Objective Structured Viva Examination lasting 66 minutes. Each carries 300 marks.

What are the prerequisite clinical requirements?

Applicants need an SLMC-registered medical degree, a recognised internship, one year of post-internship work experience in Sri Lanka, six months of a clinical appointment in Obstetrics & Gynaecology (internship included), a certificate of participation in an Advanced Life Support course run by the College of Anaesthesiologists & Intensivists of Sri Lanka, and a fitness certificate from a board-certified specialist physician.

What marks are required to pass the selection examination?

Scoring 50% or more in the MCQ paper allows a candidate to proceed to the written paper and OSVE. Passing requires 450 or more of 900 marks in aggregate, with at least 150 of 300 in each of the MCQ paper, the written paper and the Objective Structured Viva Examination.

What degree is awarded upon completion of residency?

Successful completion of basic and senior registrar training leads to the MD (Obstetrics and Gynaecology) degree and eligibility for board certification.

Are these official PGIM exam questions?

No. These are independent practice questions developed by OpenExamPrep for candidates preparing for the PGIM MD Obstetrics and Gynaecology selection exam.

Does this practice bank simulate the official PGIM examination format?

No. The official selection examination combines true/false and single-best-answer MCQs with a structured essay and short-answer paper and an Objective Structured Viva Examination. This is an independent English-language, four-option MCQ study bank by OpenExamPrep covering the same obstetric and gynaecological knowledge base; it is not an official paper, a format simulation, or a substitute for essay and viva practice.