FRANZCOG Written MCQ key terms

A pregnancy-specific disorder marked by new hypertension after 20 weeks plus proteinuria or maternal organ dysfunction, reflecting widespread endothelial injury and carrying risks of seizures, placental abruption and fetal growth restriction.

The occurrence of generalised tonic-clonic seizures in a woman with pre-eclampsia, in the absence of another cause such as epilepsy, and a major contributor to maternal death worldwide.

A severe variant of pre-eclampsia defined by haemolysis, elevated liver enzymes and low platelets, often presenting with right upper quadrant pain and capable of causing hepatic rupture or disseminated intravascular coagulation.

An anticonvulsant given intravenously for prevention and treatment of eclamptic seizures; toxicity is monitored through reflexes, respiratory rate and urine output, with calcium gluconate as the antidote.

Glucose intolerance first recognised during pregnancy, diagnosed by oral glucose tolerance testing, and associated with macrosomia, shoulder dystocia and later maternal type 2 diabetes.

Implantation of the placenta over or close to the internal cervical os, causing painless antepartum bleeding and usually requiring caesarean delivery because vaginal birth risks severe haemorrhage.

Premature separation of a normally implanted placenta before birth, presenting with painful vaginal bleeding, a tense uterus and fetal compromise, and complicated by coagulopathy.

Fetal blood vessels running through the membranes over the cervix unprotected by placental tissue or cord, which can rupture at membrane rupture and rapidly exsanguinate the fetus.

Bleeding from the genital tract after 20 weeks of pregnancy and before birth, with placenta praevia, placental abruption and local cervical or vaginal causes among the principal differentials.

Blood loss of 500 mL or more after vaginal birth or 1000 mL or more after caesarean, most often from uterine atony and managed with uterine massage, uterotonics, tranexamic acid and escalation as needed.

Failure of the myometrium to contract and retract effectively after delivery of the placenta, the commonest cause of postpartum haemorrhage and more frequent after prolonged labour or overdistension.

Failure to deliver the placenta within a defined interval after birth, which may result from trapped or adherent placenta and risks haemorrhage and infection, sometimes requiring manual removal.

Birth before 37 completed weeks of gestation, a leading cause of neonatal mortality and morbidity, with causes including spontaneous labour, preterm prelabour rupture of membranes and medically indicated delivery.

Rupture of the fetal membranes before 37 weeks and before labour begins, carrying risks of chorioamnionitis, cord prolapse and pulmonary hypoplasia depending on gestation, and prompting consideration of antibiotics and corticosteroids.

Betamethasone or dexamethasone given to women at risk of preterm birth to accelerate fetal lung maturation, reducing respiratory distress syndrome, intraventricular haemorrhage and neonatal death.

A suture placed around the cervix to reinforce it in women with cervical insufficiency, aiming to prolong pregnancy; it may be placed prophylactically, on ultrasound evidence of shortening, or as an emergency rescue procedure.

Painless progressive cervical dilatation in the second trimester without contractions, leading to recurrent pregnancy loss or preterm birth and often treated with cerclage or progesterone.

Infection of the membranes and amniotic fluid, usually ascending from the vagina, presenting with maternal fever, uterine tenderness and fetal tachycardia, and requiring antibiotics and prompt delivery.

A bacterium carried in the vagina or rectum of some pregnant women that can cause early-onset neonatal sepsis, prevented by intrapartum antibiotic prophylaxis in those identified as carriers or at risk.

Failure of a fetus to achieve its genetically determined growth potential, identified by estimated fetal weight below a gestational-age threshold with abnormal Doppler or growth trajectory, and linked to stillbirth and neonatal morbidity.

Ultrasound measurement of blood flow resistance in the umbilical artery, used in growth-restricted fetuses to detect placental insufficiency; absent or reversed end-diastolic flow signals severe compromise requiring delivery planning.

Failure to deliver the fetal shoulders after delivery of the head despite routine traction, an obstetric emergency managed with manoeuvres to rotate or flex the shoulders and associated with brachial plexus injury.

Excessive fetal size, often defined as estimated or actual birth weight above about 4000 to 4500 g, increasing the risk of shoulder dystocia, perineal trauma and caesarean delivery.

Descent of the umbilical cord past the presenting part after membrane rupture, compressing cord vessels and requiring emergency measures and immediate delivery to prevent fetal hypoxia.

A systemic coagulation disorder with widespread activation of clotting and consumption of platelets and factors, causing simultaneous thrombosis and bleeding, and seen in abruption, sepsis and severe pre-eclampsia.

A systemic infection in a newborn, classified as early onset when arising within the first days after birth from maternal genital flora, or late onset from environmental sources, and treated with antibiotics.

Presence of endometrial-like tissue outside the uterine cavity, causing cyclical pelvic pain, dysmenorrhoea and infertility, and diagnosed by laparoscopy although empirical treatment is often started first.

Presence of endometrial glands and stroma within the myometrium, producing a bulky tender uterus, heavy painful periods and sometimes subfertility, diagnosed by imaging or histology after hysterectomy.

A cyst of the ovary lined by endometriotic tissue and filled with old blood, appearing as a ground-glass lesion on ultrasound and requiring careful surgical technique to preserve ovarian reserve.

A common endocrine disorder diagnosed by oligo-ovulation, clinical or biochemical hyperandrogenism and polycystic ovarian morphology, associated with insulin resistance, infertility and endometrial hyperplasia.

Failure of the ovary to release an oocyte during a menstrual cycle, producing irregular or absent menses and infertility, with causes including polycystic ovary syndrome, thyroid disease and hyperprolactinaemia.

Raised serum prolactin causing galactorrhoea, amenorrhoea and infertility through suppression of gonadotrophin release, and potentially resulting from prolactinoma, drugs or hypothyroidism.

Use of medication such as clomiphene, letrozole or gonadotrophins to restore ovulation in anovulatory infertility, requiring monitoring because of risks of multiple pregnancy and ovarian hyperstimulation.

An iatrogenic complication of gonadotrophin stimulation with ovarian enlargement and capillary leak causing ascites, haemoconcentration and, in severe cases, thrombosis and renal impairment.

Heavy menstrual bleeding that interferes with physical, social or emotional quality of life, commonly caused by fibroids, adenomyosis, coagulopathy or endometrial pathology and managed medically or surgically.

A benign leiomyoma of the myometrium that may cause heavy bleeding, pelvic pressure, pain or infertility depending on size and location, with treatment ranging from observation to myomectomy or embolisation.

Overgrowth of endometrial glands relative to stroma, driven by unopposed oestrogen and classified as without or with atypia, the latter carrying a significant risk of progression to endometrial carcinoma.

Malignancy arising from the endometrium, typically presenting with postmenopausal bleeding and often associated with oestrogen excess, obesity and unopposed hormone exposure; diagnosis requires endometrial sampling.

Any vaginal bleeding occurring after 12 months of amenorrhoea in a woman not on hormone therapy, requiring investigation for endometrial carcinoma even though most causes are benign.

Periodic testing of the cervix, using cytology or human papillomavirus testing, to detect precancerous changes before invasive cancer develops, with abnormal results triaged by colposcopy.

Pre-invasive squamous abnormality of the cervix graded by the proportion of epithelium involved, strongly linked to high-risk human papillomavirus and treated by excision or ablation when significant.

Magnified examination of the cervix, vagina and vulva after application of dilute acetic acid, used to localise abnormal epithelium and guide biopsy or treatment of screen-detected lesions.

Implantation of a pregnancy outside the uterine cavity, most often in the fallopian tube, presenting with pain and bleeding and potentially rupturing to cause life-threatening intra-abdominal haemorrhage.

A folate antagonist used in selected stable, unruptured ectopic pregnancies and in some gynaecological conditions; it requires reliable follow-up of human chorionic gonadotrophin and avoidance of pregnancy afterwards.

Painful menstruation, classified as primary when no pelvic pathology is present and secondary when caused by conditions such as endometriosis, adenomyosis or fibroids, and treated with anti-inflammatory drugs or hormones.

Infection of the upper female genital tract, usually sexually transmitted, causing pelvic pain and fever and risking tubal damage, infertility and ectopic pregnancy if not treated promptly.

Twisting of the ovary and its vascular pedicle, producing sudden severe unilateral pain with nausea and requiring urgent surgical detorsion to preserve ovarian function.

A fluid-filled structure within the ovary, most being benign and physiological, but requiring assessment for malignancy features and consideration of surgery if persistent, large or symptomatic.

Descent of the uterus, bladder, rectum or other pelvic structures through the vagina, related to childbirth and connective tissue weakness, and managed with pessaries, pelvic floor therapy or surgery.

Involuntary leakage of urine, commonly stress incontinence from urethral support failure or urgency incontinence from bladder overactivity, assessed with history, examination and urodynamic testing when needed.

Permanent cessation of menstruation resulting from loss of ovarian follicular activity, diagnosed retrospectively after 12 months of amenorrhoea, and often accompanied by vasomotor symptoms and bone loss.

Oestrogen with or without progestogen given to relieve menopausal symptoms and prevent bone loss, with benefits and risks that must be individualised according to age, time since menopause and comorbidities.

Analysis of embryos created by in vitro fertilisation to identify chromosomal or single-gene abnormalities before transfer, aiming to improve outcomes for couples at known genetic or recurrent pregnancy-loss risk.

Assisted reproduction in which oocytes are collected and fertilised outside the body before embryo transfer, used for tubal disease, severe male factor infertility and other refractory causes.