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Self-Assessment Questions

Obstetrics & Gynecology

Rheus Alloimmunization: Review Questions

Serdar H. Ural, MD, FACOG

Dr. Ural is an assistant professor of obstetrics and gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.



Choose the single best answer for each question.

Questions 1-3 refer to the following case.

A 24-year-old gravida 2 para 1 woman is rhesus (Rh) negative. At 16 weeks of gestation, results of an indirect Coombs test are 1:8. At her next prenatal visit at 21 weeks of gestation, her antibody titer level rises to 1:64. Her past medical and surgical history are unremarkable. She has no known drug allergies. The patient’s past obstetric history is remarkable for a normal spontaneous vaginal delivery 3 years prior to the current pregnancy. She states that she had no problems in her previous pregnancy that she can remember. Her prenatal history for this pregnancy has been uneventful.


1. Which of the following are options for the next step in the management of this patient’s pregnancy?
  1. Amniocentesis or fetal echocardiogram
  2. Amniocentesis or middle cerebral artery (MCA) Doppler assessment
  3. Chorionic villi sampling or amniocentesis
  4. MCA Doppler assessment or fetal echocardiogram
  5. Chorionic villi sampling or MCA Doppler assessment
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2. What is the rate of miscarriage following amniocentesis in this setting?

  1. 1/10 procedures
  2. 1/100 procedures
  3. 1/250 procedures
  4. 1/2500 procedures
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3. The case patient is now at 28 weeks’ gestation, and it is determined that the fetus has severe anemia. Which of the following is the next step in this patient’s management?
  1. Amniocentesis
  2. Cesarean delivery
  3. Expectant management
  4. Intrauterine transfusion
  5. MCA Doppler assessment
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4. All of the following are findings of fetal hydrops on obstetric ultrasound EXCEPT:

  1. Scalp edema
  2. Ascites
  3. Pericardial effusion
  4. Enlarged fetal bladder
  5. Pleural effusion
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