100+ Free Dip Obst(SA) Practice Questions

Explanation: HIV testing with same-day result is offered at the first antenatal booking visit per SA guidelines, enabling early initiation of antiretroviral therapy (TLD) to achieve viral suppression before delivery. OGTT is performed at 24–28 weeks for gestational diabetes screening. GBS screening is not routine in SA primary antenatal care.

Explanation: Maternity Care in SA recommends a minimum of 8 antenatal visits for uncomplicated pregnancies, with the first visit before 20 weeks, visits at 20, 26, 30, 34, 36, 38, and 40 weeks. Fewer than 8 visits is associated with increased perinatal mortality in resource-limited settings.

Explanation: Placenta praevia presents with painless antepartum haemorrhage, typically in the second or third trimester, with the placenta implanted over or near the internal cervical os. Placental abruption causes painful bleeding with a tender, woody uterus. Digital vaginal examination is contraindicated until praevia is excluded.

Explanation: From 20 weeks, SFH in centimetres should approximate gestational age in weeks (±2–3 cm). An SFH of 26 cm at 32 weeks suggests lagging fundal growth, raising concern for fetal growth restriction (SGA). Ultrasound for estimated fetal weight and umbilical artery Doppler is indicated.

Explanation: Mild-to-moderate antenatal anaemia (Hb 8–10.9 g/dL) is managed with oral iron supplementation (ferrous sulphate 200 mg daily) plus dietary counselling and deworming if indicated. Blood transfusion is reserved for severe symptomatic anaemia (typically Hb <7 g/dL or Hb <8 g/dL with cardiac compromise).

Explanation: Vaginal bleeding at any stage of pregnancy is an antenatal danger sign requiring urgent assessment to exclude placenta praevia, abruption, or miscarriage. Mild dependent oedema, Braxton Hicks contractions, and heartburn are common benign pregnancy symptoms when not accompanied by danger features.

Explanation: A previous low transverse uterine incision is the strongest predictor of successful VBAC with lower uterine rupture risk (~0.5–1%) compared to classical incision (4–9% rupture risk). Classical incision, extreme obesity, and suspected macrosomia are relative or absolute contraindications to VBAC in district settings.

Explanation: Placental abruption presents with painful vaginal bleeding, a tender woody uterus, and fetal compromise or death. Risk is increased in multiple pregnancy, hypertension, and trauma. Placenta praevia causes painless bleeding. Uterine inversion occurs postpartum, not antenatally.

Explanation: Benzathine benzylpenicillin remains the treatment of choice for syphilis in pregnancy, given as 2.4 million units IM weekly for 3 weeks (late latent or unknown duration). Adequate treatment prevents congenital syphilis. Doxycycline is contraindicated in pregnancy. Azithromycin and single-dose ceftriaxone are inadequate for established syphilis.

Explanation: SA guidelines recommend immediate lifelong ART (TLD as first-line) for all HIV-positive pregnant women at diagnosis (Treat All policy), regardless of CD4 count, to achieve viral suppression and prevent mother-to-child transmission. Zidovudine monotherapy is obsolete. ART must not be deferred.