AMC MCQ Pregnancy and antenatal care Questions: 10 Free Practice MCQs

Ten AMC MCQ-style pregnancy and antenatal care questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 31 pregnancy and antenatal care questions and many more across every topic.

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1. 1 / 10

   A 31-year-old woman at 32 weeks gestation has been involved in a low speed collision. She has no vaginal bleeding and no abdominal pain, but on examination the uterus is tender and she is having more than one contraction every ten minutes. The cardiotocograph is normal.

   How long should fetal monitoring continue?

   • A. No monitoring is required because the mechanism of injury was minor
   • B. Four hours of cardiotocography is sufficient if the trace remains normal
   • C. Extend cardiotocography to 24 hours
   • D. Monitor until she has been free of pain for two hours
   • E. Stop monitoring once a formal obstetric ultrasound is normal
   Show answer

   Answer: C. Extend cardiotocography to 24 hours

   Why: At 22 weeks gestation or more, continuous cardiotocography is commenced as soon as feasible and continued for a minimum of four hours after any maternal trauma, because the fetal heart rate is a sensitive surrogate for maternal perfusion and can change before maternal deterioration is apparent. Monitoring is extended to 24 hours when there is more than one contraction every ten minutes, uterine tenderness, significant abdominal pain, ruptured membranes, vaginal bleeding, a positive Kleihauer-Betke test or an abnormal trace, and this woman has two of those features. Mild trauma does not exempt her from monitoring, symptoms are an unreliable guide, and a normal ultrasound does not exclude abruption.

   • A. Even minor injuries are associated with placental abruption, preterm labour and fetal loss, and around half of fetal losses follow minor trauma.
   • B. Four hours is only the minimum after trauma, and her uterine tenderness and frequent contractions are indications to extend monitoring.
   • D. Relying on symptoms under-estimates risk, because abruption can occur with few symptoms and initially normal observations.
   • E. Ultrasound is not sensitive enough to exclude abruption, for which false negative rates are high, so it cannot end monitoring.

   Sources: Queensland Clinical Guidelines. Traumatic injury in pregnancy. Guideline No. MN26.31-V3-R31. Queensland Health. 2026.

2. 2 / 10

   A 28-year-old woman at 8 weeks gestation eats a mixed diet that includes seafood about once a week. She asks whether she should take an iodine supplement and at what dose.

   What supplement dose does RANZCOG recommend for pregnant women?

   • A. No iodine supplement is needed if seafood is eaten weekly
   • B. 50 micrograms daily
   • C. 150 micrograms daily
   • D. 300 micrograms daily
   Show answer

   Answer: C. 150 micrograms daily

   Why: Iodine deficiency appears to be increasing in frequency and even subclinical hypothyroidism may have clinical sequelae, so avoiding iodine deficiency in pregnancy is important. RANZCOG recommends that women who are pregnant, breastfeeding or considering pregnancy take an iodine supplement of 150 micrograms each day. This recommendation is not conditional on dietary seafood intake, and doses of 50 or 300 micrograms are not the recommended amounts.

   • A. Dietary seafood does not remove the need for supplementation, because the recommendation applies to all women who are pregnant, breastfeeding or considering pregnancy.
   • B. This is below the recommended intake and would not meet the additional iodine requirement of pregnancy.
   • D. No 300 microgram dose is recommended for routine pregnancy supplementation in this statement.

   Sources: RANZCOG Vitamin and Mineral Supplementation in Pregnancy (C-Obs 25), November 2019

3. 3 / 10

   A 33-year-old woman at 28 weeks gestation attends for a routine antenatal visit. She feels well and reports normal fetal movements. The midwife palpates the abdomen before measuring the symphysio-fundal height.

   What is the recommended approach to this measurement?

   • A. Measure and record the value without plotting it on a chart
   • B. Measure only when the woman reports reduced fetal movements
   • C. Plot the measurement on a customised antenatal growth chart at each visit
   • D. Replace the measurement with a growth scan at this visit
   Show answer

   Answer: C. Plot the measurement on a customised antenatal growth chart at each visit

   Why: Clinical assessment at each antenatal visit should include measurement of the symphysio-fundal height to assist in detection of abnormal fetal growth. RANZCOG recommends that this measurement is plotted on a customised antenatal growth chart, taking maternal size into account, and that early pregnancy risk selection is undertaken for fetal growth restriction with serial scanning for women who have specific risk factors. Measurement takes minimal time and has no cost, and it complements rather than replaces targeted ultrasound.

   • A. Recording without plotting loses the trend that makes serial measurements useful for detecting abnormal fetal growth.
   • B. Symphysio-fundal height measurement is a routine part of every antenatal visit, not a response to reported symptoms.
   • D. Ultrasound is used selectively when growth is a concern and does not replace routine clinical measurement at each visit.

   Sources: RANZCOG Routine antenatal assessment in the absence of pregnancy complications (C-Obs 3b), March 2022

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5. 4 / 10

   A 29-year-old woman who is 22 weeks pregnant has a severe psychotic depression with refusal of food and fluid. She is deteriorating and a decision about physical treatment is needed.

   What does the RANZCP ECT guideline say about using electroconvulsive therapy in this patient?

   • A. It is contraindicated at every stage of pregnancy
   • B. It should be deferred until after delivery
   • C. It requires caesarean section beforehand
   • D. It should be replaced by high-dose benzodiazepines until delivery
   • E. It can be used, with specific considerations for the pregnant patient
   Show answer

   Answer: E. It can be used, with specific considerations for the pregnant patient

   Why: The professional practice guideline states that specific considerations are required when using electroconvulsive therapy in the treatment of children and adolescents, pregnant women, and people with comorbid medical issues, so pregnancy prompts additional care rather than exclusion. Deferring treatment until after delivery or substituting sedatives leaves a severe psychotic depression untreated. The guideline does not require caesarean section before treatment, and the combination of dosing, electrode placement, pulse width, session frequency, concomitant medication and anaesthetic approach is individualised to the patient.

   • A. Pregnancy is not an absolute bar to treatment, and the guideline instead asks for specific considerations in this group.
   • B. Waiting until after delivery would leave a deteriorating psychotic depression untreated for many weeks.
   • C. The guideline does not require obstetric surgery before treatment and addresses instead the specific considerations pregnancy brings.
   • D. Sedatives do not treat psychotic depression and would not deliver the response this woman's deterioration requires.

   Sources: RANZCP Electroconvulsive therapy professional practice guideline (April 2019)

6. 5 / 10

   A 26-year-old woman is 9 weeks pregnant with her first baby. She has no medical conditions, a body mass index of 23 and no pregnancy complications. She is planning her work leave and asks how many antenatal appointments she will need if the pregnancy remains uncomplicated.

   According to RANZCOG, what schedule of antenatal visits is adequate for this nulliparous woman without complications?

   • A. Four visits spaced through the pregnancy
   • B. Six visits with the final visit at 36 weeks
   • C. Ten visits
   • D. Weekly visits from 20 weeks
   Show answer

   Answer: C. Ten visits

   Why: The schedule of antenatal visits should be determined by the individual woman's needs. RANZCOG states that for a nulliparous woman without complications a schedule of ten visits should be adequate. Four or six visits would reduce surveillance and education opportunities, while weekly review from 20 weeks is far more intensive than an uncomplicated pregnancy requires. Visits are usually spaced further apart in early pregnancy and become more frequent towards term.

   • A. Restricting care to four visits would reduce the opportunities for ongoing screening, growth assessment and preparation for birth that routine antenatal care provides.
   • B. A six visit schedule ends antenatal review too early and does not match the schedule the college describes for a first uncomplicated pregnancy.
   • D. Weekly review from 20 weeks would be far more intensive than an uncomplicated first pregnancy requires and is not the schedule described.

   Sources: RANZCOG Routine antenatal assessment in the absence of pregnancy complications (C-Obs 3b), March 2022

7. 6 / 10

   A 28-year-old woman who is 20 weeks pregnant presents with severe right loin pain, vomiting and microscopic haematuria. She is afebrile and her renal function is normal. Ureteric calculus is suspected.

   Which imaging investigation should be performed first?

   • A. Non-contrast CT of the kidneys, ureters and bladder
   • B. Intravenous pyelogram
   • C. Renal tract ultrasonography
   • D. Magnetic resonance imaging of the abdomen
   Show answer

   Answer: C. Renal tract ultrasonography

   Why: Ultrasonography is the useful first-line tool in pregnancy because it identifies calculi in the renal calyx, pelvis and ureter and detects hydroureter or hydronephrosis without radiation. Non-contrast CT is the gold standard for most patients but its radiation dose makes it less appropriate here, and intravenous pyelography adds both radiation and contrast exposure. Magnetic resonance imaging is not the recommended first-line study for suspected ureteric calculi and is reserved for selected problem solving.

   • A. CT is the gold standard for most patients, but its radiation exposure makes it a less appropriate first test in pregnancy.
   • B. Intravenous pyelography exposes both the woman and the fetus to radiation and contrast and is not the preferred initial study.
   • D. MRI is not the first-line modality recommended for suspected ureteric calculi and is reserved for selected problem solving.

   Sources: AJGP An update on management of renal colic (2021)

8. 7 / 10

   A 34-year-old woman at 37+4 weeks has a singleton breech presentation. She reports a small amount of vaginal bleeding that started three days ago. Ultrasound shows a normally sited placenta and the cardiotocograph is normal. She asks about external cephalic version.

   Which finding in her history is an absolute contraindication to external cephalic version?

   • A. Nulliparity
   • B. Normal cardiotocography
   • C. Antepartum haemorrhage within the last 7 days
   • D. A normally sited placenta
   • E. Breech presentation at 37 weeks with an engaged presenting part
   Show answer

   Answer: C. Antepartum haemorrhage within the last 7 days

   Why: Antepartum haemorrhage within the last 7 days is listed as an absolute contraindication to external cephalic version, alongside placenta praevia, abnormal cardiotocography, ruptured membranes, rhesus isoimmunisation and multiple pregnancy. Bleeding in the preceding week may reflect a small abruption that version could extend. Nulliparity reduces the success rate to about 40 per cent but is not a contraindication, a normal cardiotocograph supports proceeding, a normally sited placenta removes the praevia concern, and breech presentation is the very indication for the procedure.

   • A. A first pregnancy lowers the chance of success but is not a listed contraindication to version.
   • B. A normal tracing is reassuring, whereas an abnormal tracing would prohibit the procedure.
   • D. A placenta well clear of the cervical os removes the praevia concern that would otherwise bar version.
   • E. Malpresentation is the indication for version rather than a reason to avoid it.

   Sources: RANZCOG Management of Breech Presentation (C-Obs 11), 2021

9. 8 / 10

   A 35-year-old woman, para 1, is having a planned vaginal breech birth at term in a unit with continuous fetal monitoring and immediate access to theatre. She is fully dilated and a passive second stage has been allowed for descent. Two hours have passed and the breech is still not visible.

   What should be recommended?

   • A. Active pushing to bring the breech down
   • B. A further two hours of passive descent
   • C. Oxytocin augmentation to strengthen contractions for a further hour of passive descent
   • D. Forceps applied to the aftercoming head
   • E. Caesarean section, because the breech is not visible after two hours of passive second stage
   Show answer

   Answer: E. Caesarean section, because the breech is not visible after two hours of passive second stage

   Why: A passive second stage is recommended to allow the breech to descend before active pushing begins, but if the breech is not visible within two hours of that passive second stage, caesarean section should be recommended. Pushing before the breech is visible, or allowing another two hours, goes against that guidance. Augmentation is avoided in a planned vaginal breech birth because adequate progress is the best evidence of fetopelvic proportions, and forceps cannot be applied to an aftercoming head that has not descended to view. Supervision of this labour should involve an experienced obstetrician with theatre immediately available.

   • A. Active pushing is not encouraged until the breech becomes visible.
   • B. Allowing more time goes beyond the two hour point at which caesarean section is recommended.
   • C. Augmentation is avoided in this setting because adequate progress is the best evidence of fetopelvic proportions.
   • D. Applying forceps to the aftercoming head before it is visible is not appropriate.

   Sources: RANZCOG Management of Breech Presentation (C-Obs 11), 2021

10. 9 / 10

    A 26-year-old woman at 24 weeks gestation is Rh D negative. After a fall down stairs she has a small abdominal haematoma and uterine tenderness. She is haemodynamically stable and there is no vaginal bleeding.

    Which action is required in addition to her trauma assessment?

    • A. Withhold prophylaxis until the fetal heart rate has been monitored for 24 hours
    • B. Send a Kleihauer-Betke test and give Rh D immunoglobulin without delaying definitive care
    • C. Give Rh D immunoglobulin only if she becomes haemodynamically unstable
    • D. Rely on the Kleihauer-Betke test to diagnose placental abruption
    • E. Arrange immediate delivery because abdominal trauma after 20 weeks mandates birth
    Show answer

    Answer: B. Send a Kleihauer-Betke test and give Rh D immunoglobulin without delaying definitive care

    Why: Abdominal trauma is a sensitising event, so an Rh D negative woman of 13 weeks gestation or more needs a Kleihauer-Betke test to detect and quantify feto-maternal haemorrhage and Rh D immunoglobulin to prevent sensitisation. Both should be arranged without delaying the trauma assessment or any other definitive care. The Kleihauer-Betke test is not a test for placental abruption and does not diagnose it, maternal haemodynamic instability is not a prerequisite for prophylaxis, and trauma after 20 weeks does not by itself require delivery. Withholding immunoglobulin until monitoring is complete would leave the woman exposed to sensitisation during the very period of highest risk.

    • A. Rh D immunoglobulin should not be delayed while awaiting monitoring, because abdominal trauma in an Rh D negative woman is a sensitising event.
    • C. Maternal instability is not required for prophylaxis, which is indicated after abdominal trauma at this gestation regardless of how stable she appears.
    • D. The Kleihauer-Betke test quantifies feto-maternal haemorrhage and is not a test for placental abruption.
    • E. Trauma does not by itself mandate delivery, and management depends on maternal and fetal condition, with most women needing monitoring rather than immediate birth.

    Sources: Queensland Clinical Guidelines. Traumatic injury in pregnancy. Guideline No. MN26.31-V3-R31. Queensland Health. 2026.

11. 10 / 10

    A 24-year-old pregnant woman at 28 weeks gestation presents for her routine antenatal check. She received a pertussis booster (dTpa) 12 months ago prior to becoming pregnant.

    What is the recommended advice regarding pertussis vaccination during this pregnancy?

    • A. She does not require vaccination as her booster 12 months ago provides sufficient protection.
    • B. Defer vaccination until immediately postpartum (cocooning strategy).
    • C. She should receive a dose of dTpa now during this pregnancy.
    • D. Administer the monovalent pertussis vaccine instead of the triple antigen dTpa.
    Show answer

    Answer: C. She should receive a dose of dTpa now during this pregnancy.

    Why: To optimize the transfer of protective maternal antibodies to the foetus, a dose of dTpa (diphtheria-tetanus-acellular pertussis) vaccine is recommended during every pregnancy (ideally between 20-32 weeks), regardless of the interval since the last dose.

    • A. Maternal antibody levels peak shortly after vaccination and must be boosted.
    • B. Postpartum vaccination does not provide transplacental protection to the newborn.
    • D. Monovalent pertussis vaccine is not available in Australia.

    Sources: Australian Immunisation Handbook

Exam-style questions written by MedHub for practice. They are not official exam questions.