100+ Free MRCOG Part 2 Practice Questions

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A multiparous woman in labour is noted to have a transverse lie at 39 weeks with intact membranes and the fetus is alive. She is 3 cm dilated. What is the most appropriate management?

Perform amniotomy to encourage descent

Arrange caesarean section, as vaginal birth is not possible with a persistent transverse lie

Apply forceps once fully dilated

Allow labour to continue and reassess later

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Sample MRCOG Part 2 Practice Questions

Try these sample questions to test your MRCOG Part 2 exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old woman attends her booking appointment at 9 weeks. She has a BMI of 32 and no other risk factors. According to NICE guidance, what is the most appropriate advice regarding aspirin for pre-eclampsia prophylaxis?

A.Aspirin is not indicated as she has only one moderate risk factor

B.Start aspirin 75-150 mg daily from 12 weeks

C.Start aspirin 150 mg daily immediately

D.Start low-dose aspirin only if she develops hypertension

Explanation: NICE recommends aspirin 75-150 mg daily from 12 weeks for women with one HIGH risk factor or two or more MODERATE risk factors. A BMI of 30 or more is a single moderate risk factor, so aspirin is not indicated unless a second moderate or one high risk factor is present.

2A 30-year-old woman who is rhesus D negative delivers a rhesus D positive baby at term. A Kleihauer test estimates a fetomaternal haemorrhage of 6 mL of fetal red cells. She has already received the routine postnatal 1500 IU anti-D. What is the most appropriate action?

A.No further anti-D is required

B.Repeat the Kleihauer in 72 hours

C.Give an additional dose of anti-D as the 1500 IU covers only 4 mL of fetal red cells

D.Give intravenous immunoglobulin instead

Explanation: A 1500 IU (300 microgram) dose of anti-D covers approximately 4 mL of fetal red cells (about 8 mL of fetal whole blood). With a 6 mL fetal red cell bleed, the routine dose is insufficient and additional anti-D, guided by the Kleihauer estimate, must be given to prevent sensitisation.

3A 32-year-old woman attends for her combined screening test at 12 weeks. The result gives a chance of trisomy 21 of 1 in 80. Under the NHS Fetal Anomaly Screening Programme, what should be offered next?

A.Immediate chorionic villus sampling

B.Amniocentesis at 15 weeks only

C.Repeat the combined test in two weeks

D.Non-invasive prenatal testing (cell-free DNA) as a contingent test

Explanation: Under the NHS FASP, a higher-chance combined screening result (1 in 150 or greater chance) leads to an offer of non-invasive prenatal testing (cell-free DNA) as a contingent test, or the option of invasive diagnostic testing. NIPT is highly sensitive and reduces the number of invasive procedures.

4A 26-year-old primigravida presents at 34 weeks with reduced fetal movements for 24 hours. The cardiotocograph is normal and fetal growth is appropriate. What is the most appropriate initial management?

A.Immediate delivery by caesarean section

B.Confirm fetal wellbeing with CTG, and arrange an ultrasound scan for growth and liquor if not done recently

C.Reassure and arrange routine follow-up

D.Admit for continuous CTG monitoring for 48 hours

Explanation: For a first episode of reduced fetal movements after 28 weeks with a normal CTG, fetal wellbeing should be confirmed and an ultrasound assessment of growth, liquor and umbilical artery Doppler arranged if there has not been a recent scan. This identifies the small proportion with underlying growth restriction.

5A 35-year-old woman with a dichorionic diamniotic twin pregnancy asks about the recommended timing of birth in an otherwise uncomplicated pregnancy. According to NICE guidance on twin pregnancy, what is the recommended timing of birth?

A.From 37 weeks

B.From 34 weeks

C.From 32 weeks

D.From 40 weeks

Explanation: NICE recommends offering elective birth from 37 weeks 0 days for uncomplicated dichorionic diamniotic twin pregnancies, as continuing beyond this increases the risk of stillbirth. Monochorionic diamniotic twins are offered birth from 36 weeks with steroids.

6A 29-year-old woman at 28 weeks is found to have a fasting plasma glucose of 5.8 mmol/L on her oral glucose tolerance test. According to NICE diagnostic thresholds, what is the diagnosis and most appropriate first-line intervention?

A.Normal result; no action needed

B.Gestational diabetes; start insulin immediately

C.Gestational diabetes; offer a trial of diet and exercise as fasting glucose is below 7 mmol/L

D.Overt pre-existing diabetes; refer to the diabetes team

Explanation: NICE diagnoses gestational diabetes with a fasting plasma glucose of 5.6 mmol/L or above or a 2-hour value of 7.8 mmol/L or above. With a fasting glucose of 5.8 mmol/L (below 7 mmol/L), a trial of diet and exercise for 1-2 weeks is appropriate first-line before considering metformin or insulin.

7A woman at 30 weeks is identified as having a small-for-gestational-age fetus with an estimated fetal weight on the 5th centile. Umbilical artery Doppler shows absent end-diastolic flow. What is the most appropriate management?

A.Reassure and rescan in four weeks

B.Switch surveillance to fortnightly umbilical artery Doppler only

C.Deliver immediately by caesarean section regardless of gestation

D.Admit for surveillance and consider delivery with steroids, using ductus venosus Doppler and CTG to time birth

Explanation: Absent end-diastolic flow in the umbilical artery indicates significant placental compromise. The fetus should be admitted for intensified surveillance, antenatal corticosteroids given, and birth timed using ductus venosus Doppler and computerised CTG, typically by around 32 weeks if absent end-diastolic flow persists.

8A 24-year-old woman at 39 weeks has a confirmed primary genital herpes lesion. What is the most appropriate advice regarding mode of delivery?

A.Vaginal delivery is safe as she has antibodies

B.Recommend caesarean section to reduce the risk of neonatal herpes

C.Induce labour to expedite vaginal birth

D.Delay delivery until lesions heal

Explanation: A primary genital herpes infection acquired in the third trimester carries a high risk of neonatal herpes because the mother has not yet developed protective antibodies to pass to the fetus. Caesarean section is recommended, particularly when the primary episode occurs within six weeks of delivery.

9A 27-year-old woman at 36 weeks has an ultrasound showing the placenta covering the internal cervical os. She is asymptomatic. What is the most appropriate plan for mode and timing of birth?

A.Plan elective caesarean section, typically between 36 and 37 weeks

B.Aim for vaginal delivery at term

C.Induce labour at 38 weeks

D.Repeat scan at 40 weeks before deciding

Explanation: A placenta covering the internal os (placenta praevia) is an absolute indication for caesarean section. For an uncomplicated placenta praevia, elective caesarean is planned around 36 to 37 weeks to balance prematurity against the risk of unscheduled bleeding and emergency delivery.

10A woman with a previous classical (vertical) caesarean section asks about her options for the current pregnancy. What is the most appropriate advice regarding mode of birth?

A.Vaginal birth after caesarean is recommended

B.Induction of labour with prostaglandins is safe

C.Elective repeat caesarean section is recommended because of the high uterine rupture risk

D.The previous incision type makes no difference to the rupture risk

Explanation: A previous classical (upper segment vertical) caesarean carries a substantially higher risk of uterine rupture (around 2-9%) than a low transverse incision. Vaginal birth after caesarean is contraindicated, and an elective repeat caesarean is recommended, often slightly earlier than term.

About the MRCOG Part 2 Exam

The MRCOG Part 2 is a computer-based test delivered through Pearson VUE that assesses the application of clinical knowledge in obstetrics and gynaecology. It comprises two 3-hour papers, each with 50 SBAs and 50 EMQs, and must be passed before progressing to the MRCOG Part 3 clinical assessment.

Assessment

Two computer-based papers taken on the same day; each paper has 50 Single Best Answer (SBA) and 50 Extended Matching (EMQ) questions, giving 200 items in total.

Time Limit

3 hours per paper (6 hours total) with an approximately 60-minute lunch break between papers.

Passing Score

No fixed percentage; each diet has a unique combined pass mark determined by standard-setting (SBAs contribute 40% and EMQs 60% of the marks).

Exam Fee

Approximately GBP 550 for UK & Republic of Ireland candidates; banded by country per RCOG 2025 fees (Band A approx GBP 663, Band B approx GBP 572, Band C approx GBP 456). (Royal College of Obstetricians and Gynaecologists (RCOG))

MRCOG Part 2 Exam Content Outline

16%

Antenatal Care

Routine and high-risk antenatal management, aneuploidy screening, fetal growth and surveillance, multiple pregnancy and antepartum haemorrhage.

17%

Maternal Medicine

Hypertensive disorders, diabetes, venous thromboembolism, cardiac, thyroid, liver and infectious disease in pregnancy.

10%

Management of Labour

Intrapartum monitoring and CTG interpretation, labour progress, induction, preterm labour and obstetric emergencies.

Management of Delivery

Instrumental and operative delivery, perineal trauma classification, retained placenta and placenta accreta spectrum.

Postpartum Problems

Postpartum haemorrhage, puerperal sepsis, perinatal mental health, mastitis and postnatal thromboembolism.

10%

Gynaecological Problems

Heavy menstrual bleeding, fibroids, endometriosis, PCOS, menopause, ovarian cysts and emergency gynaecology.

Sexual and Reproductive Health

Contraception and UKMEC, emergency contraception, sexually transmitted infections, abortion care, consent and Fraser guidelines.

Early Pregnancy Care

Miscarriage, ectopic pregnancy, hyperemesis gravidarum, recurrent miscarriage and gestational trophoblastic disease.

Gynaecological Oncology

Cervical screening and cancer, endometrial, ovarian and vulval cancer, FIGO staging and risk-reducing surgery.

Subfertility

Investigation of subfertility, ovulation induction, tubal and male factor, IVF and ovarian hyperstimulation syndrome.

Urogynaecology and Pelvic Floor

Stress and urge incontinence, overactive bladder, pelvic organ prolapse, pessaries and urodynamics.

Clinical Governance and EBM

Clinical audit, consent and the Montgomery standard, duty of candour, statistics, screening test performance and critical appraisal.

How to Pass the MRCOG Part 2 Exam

What You Need to Know

Passing score: No fixed percentage; each diet has a unique combined pass mark determined by standard-setting (SBAs contribute 40% and EMQs 60% of the marks).
Assessment: Two computer-based papers taken on the same day; each paper has 50 Single Best Answer (SBA) and 50 Extended Matching (EMQ) questions, giving 200 items in total.
Time limit: 3 hours per paper (6 hours total) with an approximately 60-minute lunch break between papers.
Exam fee: Approximately GBP 550 for UK & Republic of Ireland candidates; banded by country per RCOG 2025 fees (Band A approx GBP 663, Band B approx GBP 572, Band C approx GBP 456).

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

MRCOG Part 2 Study Tips from Top Performers

1Anchor your revision in the source material the exam uses: RCOG Green-top Guidelines, relevant NICE guidance and recent TOG articles, rather than relying on a single textbook.

2Practise applying guidelines to clinical vignettes under timed conditions, since the SBAs reward choosing the single best management option, not just recalling facts.

3Deliberately revise the smaller, often weaker gynaecology modules (subfertility, urogynaecology, oncology and early pregnancy) early so you have time to close knowledge gaps.

Frequently Asked Questions

How many questions are on the MRCOG Part 2 exam?

The MRCOG Part 2 has 200 items in total, split across two papers. Each paper contains 50 Single Best Answer (SBA) questions and 50 Extended Matching Questions (EMQs).

How is the MRCOG Part 2 scored and what is the pass mark?

There is no fixed pass mark. Each diet is standard-set, so the pass mark varies with exam difficulty. SBAs contribute 40% and EMQs 60% to the overall mark, with a single combined pass standard.

How long is the MRCOG Part 2 exam?

It is six hours of testing in total: two computer-based papers of three hours each, taken on the same day with an approximately 60-minute lunch break between them.

Where is the MRCOG Part 2 delivered?

The MRCOG Part 2 is a computer-based test delivered at Pearson VUE test centres worldwide. Candidates apply via the RCOG website and book a test centre place when applications open.