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Hematology Maternal medicine Module part2

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1)

A 31-year-old woman in her first pregnancy books with the midwife at 10 weeks of gestation. A
full blood count taken at this time gives the following result:
• Hb = 112g/L
• WCC = 4.0
• Platelets = 89
• MCV = 30
• MCH = 35.
She has suffered with nose bleeds in the past but has never been investigated. Most probable
diagnosis is

2) Which of the following statement regarding inherited bleeding disorder is true;

3) In case of neonanatal management of severely affected male fetus of hemophilia;

4)

A 26-year-old primpiparous woman with known idiopathic immune thrombocytopenia presents
in spontaneous labour at 38 weeks of gestation. She has not required any treatment for this
condition in her pregnancy. She has a normal BMI of 22.
On admission to the labour ward a full blood count is taken, with the following result:
• Hb = 108 g/L
• WCC = 10.0
• platelets = 90.
An hour later, spontaneous rupture of membranes occurs. There is meconium-stained liquor and the
CTG is pathological, with a baseline of 150 bpm, variability <5 and variable decelerations. On vaginal examination she is 5 cm dilated. What is the most appropriate next step in her management?

5) Fluid restriction during DDAVP treatment is required to prevent

6) About coagulation mechanism in pregnancy; following statement is true;

7)

A 34-year-old primigravida presents for her booking visit at 32 weeks' gestation. She has a
booking blood pressure of 111/70 mmHg and a urine dipstick shows leucocytes ++. In her history she
mentions that she always has had heavy periods. She also shows some petichae in her arms, which
she says happen without any obvious trauma, and resolve spontaneously. Her blood tests were as
follows:
• haemoglobin = 126 g/l
• white cell count = 11
• renal function tests = normal
• liver function tests = normal
• platelet count = 50
• anticardiolipin antibodies/lupus anticoagulant and SLE serology = normal
• coagulation profile = normal
• infection screen = normal.
What would be the most appropriate management for her

A 19-year-old white British woman who had a normal delivery 2 years before is referred to the
antenatal clinic at 31 weeks of gestation by her community midwife. She was found to be anaemic at
28 weeks of gestation with Hb 90 g/L. She was given a prescription for oral iron and two weeks later
a repeat full blood count was as follows:
• Hb = 89 g/L
• WCC = 5.0
• platelets = 320
• MCV = 75 fl
• MCH = 30
She feels tired but is otherwise well.

8) What is the most appropriate next step in her management?

9)

A 25-year-old primparous woman is referred to the antenatal clinic for booking at 12 weeks of
gestation. The reason for referral is that her father has a history of severe haemophilia A. She wishes
to be investigated to see if her baby is affected.

What is the most appropriate initial investigation to determine the risk of the baby having
haemophilia A?

10) Following statement is true about thrombocytopenia in pregnancy

11) Following statement about iron deficiency anemia are true

12) Fluid restriction during DDAVP treatment should be

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