Maternal Physiology during Pregnancy(MCQs
1. Most state-of-the-art serum pregnancy tests have a sensitivity for detection of β-human chorionic
gonadotropin (β-hCG) of 25 mLU/ mL. Such tests would diagnose pregnancy as early as which of the
following?
(A) 5 days after fertilization
(B) 24 hours after implantation
(C) day of the expected (missed) menses
(D) 5 weeks’ gestation age by menstrual dating
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(E) 6 weeks’ gestation age by menstrual dating
Answers and explanation:-
1. (C) Circulating β-hCG in early pregnancy at a level of 25 mLU/mL is detected in most women by 12 to
13 days after the luteinizing hormone (LH) peak. Therefore, the test should be positive by the date of
the expected menses.
2. A 35-year-old G5P4004 patient is found to have ASCUS on her Pap smear done at her new obstetrics
(OB) visit. In your counseling of the patient as to what this result means, you note that the hormonal changes
of pregnancy will cause changes in the cervix. Which of the following cervical changes may be
found more frequently in the pregnant state than in the nonpregnant state?
(A) atypical glandular hyperplasia
(B) dysplasia
(C) metaplasia
(D) neoplasia
(E) vaginal adenosis
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Answers and explanation:-
2. (C) Metaplasia from hormonally induced changes in the squamocolumnar junction is common in
pregnancy. Dysplasia or atypia is not common and needs to be evaluated. The cervix can be
histologically evaluated for malignant change during pregnancy as well as during the nonpregnant state.
Pap smears and colposcopy are both reliable. Dysplasia is probably best not treated until the postpartum period. However, CIS or microinvasive cervical cancer may be treated depending on the gestational
age.
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Maternal Physiology during Pregnancy
