A 36 year-old G7PSAI woman has just delivered a 4.

200 g female infant at 39

weeks gestation. She underwent augmentation of labor with prceclampsia,
diagnosed with systolic BPs elevated to 180 mm Hg. Her pregnancy was
complicated by uncontrolled gestational diabetes. She was placed magnesium
sulfate throughout her induction for seizure prophylaxis. Her second stag of labor
lasted 1 hour, she was, however, able to deliver vaginally with McRoberts mane
and steady traction The third stage or labor lasted 10 minutes and the placenta was
delivered intact. Immediately after the third stage her bleeding was significant the
expulsion of blood and the fundus was notable soft.

1. Witch of the following are NOT risk factors for postpartum hemorrhage?
a. Second stage of labor lasted 1 hour
b. Grand multiparity
c. Magnesium sub fate
d. Microsomia
e. Over distended uterus

2. What is the most likely cause of bleeding

a. Uterine atony
b. Uterine rupture
c. Retained placenta
d. Genital tract laceration
e. DIC

3. After use of a 20 units of oxytocin in 1000 ml of crystalloid solution to

increase the tone of her uterus stop the bleeding, however. even the
contraction is firm, you continue to notice a steady stream of blood
descending from the vagina. What is the most appropriate next step in the
evaluation of this patient's bleeding?
a. Perform a bedside ultrasound for retained products of conception
b. Perform a bedside ultrasound to look for blood in the abdomen significant
for uterine rupture
 c. Perform a manual exploration of the uterine fundus and exploration for
retained clots or products
d. Examine the perineum unj vaginal for laceration during delivery
e. Consult interventional radiology for uterine artery embolization

Mrs Rina, a 26-ycor old G1P0A0 term pregnancy with preeclampsia. The fetus
was delivered by forceps Completion of the third stage followed quickly, and the
placenta was delivered intact. The fundus was firm by palpation, but brisk vaginal
bleeding was still noted. From the perineum inspection you find third degree
laceration.

4. What is the most appropriate next step in the evaluation of this patient's
bleeding?
a. Perform a bedside ultrasound for retained products of conception
b. Perform a bedside ultrasound to look for bloodin the abdomen significant
for uterine rupture
c. Perform a manual exploration of the uterine fundus and exploration for
retained clots or products
d. Inspeculo to examine the cervix and vaginal for laceration
e. Consult interventional radiology for uterine artery embolization

5. What is the most appropriate management tor the cervical laceration?

a. Surgical repair
b. Tamponade with gauze pack
c. Bakri Baloon
d. Clamp with ring forceps
e. Embolization

6. After the third-degree perineal laceration was repaired in normal standard

fashion. Which of the following consideration will happen to the patient
complication to sphincter injury
 a. Urine incontinence
b. Fecal incontinence
c. Vulvar hematoma
d. Paravaginal hematoma
e. fecal and urine incontinence

A 35-ycor-old woman (gravida 7. para 5. abortus I) is in the active phase of labor

with the vertex at -I station. She underwent induction of labor with oxytocin for
premature rupture membrane. 3 hours later, she complains of abdominal pain with
the contractions At the height of one contraction, the pain becomes very intense
Hollowing this intense pain, uterine contractions cease. The maternal systolic BP
drops 15 mm I Ig, followed by decrease of fetal heart rate

7. What is the most likely cause the decrease of fetal heart rate ?
a. Uterine atony
b. Uterine rupture
c. Retained placenta
d. Genital tract laceration
e. DIC

8. Which of the following is the dependent factor for fetal prognosis ?

a. Degree of placental maturation
b. Magnitude of maternal hemorrhage
c. Hypervolemia
d. Macrosomia
e. Grand Multiparity

9. What is the next management for this patient

a. prepare emergent Caesarean Section
b. Continue oxytocin
c. Perform an ultrasound
 d. Manage expectantly
e. Place tire patient on her side and reassure her

Women 28 years old. G1P0 at 39 weeks is in early labor She is 2 cm dilated and
90% effaced, with contractions every 4 to 5 minutes. The fetal heart tones are
teassurring. Her nurse stop out for a moment and returns to find her having a
seizure.

10. The nurse administers a 4-g magnesium bolus. The seizure stop. The fetal
heart tone variability is flat, but there are no deceleration. What would your
next therapies be aimed at?
a. Reducing edema with deurities
b. Giving hipotensive agents until the blood pressure is 110/70 mmHg
c. Giving 3 g of magnesium sulfate every 3 hours
d. Prepare for Immediate delivery by cesarean section
e. Keeping the patient free of convulsions, coma and acidosis

11. Which of the following would be the most common warning sign/symtom of
her eclamtic seizure?
a. Proteinuria
b. Severe headache
c. Facial edema
d. Increased blood pressure > 160/120 mmHg
e. Severe dyspneu

12. The patient is most at risk for mortality from which of the following
complications?
a. Infection
b. Uremia
c. Congestive heart failure
d. Fever
e. Cerebrat hemorrhage
A woman (gravida4. para 3) with 3previous successful vaginal births with
birthweight amount 3 kg. The woman has been in labor for 10 hours with a 8-hour
first stage. The second stage of labor has lasted approximately 1 hour 15 minutes.
The baby is doing well without my evidence of distress and of an appropriate size
(Approximately 3kg). The mother has tired from pushing, and you decide lo apply
forceps

13. Application of forceps it appropriate in which of the following situation?

a. breech at + 3 station, cervix completely dilated, membranes ruptured
b. vertex at + 1 station, cervix completely dilated, membranes intact
c. mentum anterior, + 3 station cervix completely dilated, membranes
ruptured
d. transverve lie, + 3 station. cervix completely dilated, membranes raptured
e. vertex at + 3 station, cervix +9 cm dilated, membranes raptured

14. Alter pelvic examination, forceps are applied to the preventing part of a term
pregnancy, hut the lock does not properly articulate even with gentle
manoeuvring. What would you do?
a. rotate the forceps
b. apply enough pressure to lock the forceps
c. esert traction
d. change with vacum extraction
e. remove the forceps and perform cesarean delivery

15. Winch the following DOES NOT influence fetal lung maturity
a. Presence or absence of labor
b. Induced versus non induced labor
c. Fetal gender
d. Maternal hypertension
e. Maternal diabetes
A patient who is a G2P1001 has been pushing for 3 hours and is exhausted after a
long labor. The fetal tracing is now a Category 2 tracing. The vertex is at +3
station. On examination, the infant Heels about 3500g and live pelvis is roomy.

16. In this case, you feel that a vacuum-assisted vaginal delivery is an indicated
option to expedite delivery In your counselling of the patient, you tell her that
the most severe fetal complications of vacuum extraction for the fetus include
which of the following?
a. subgaleal haemorrhage
b. cephalhematoma
c. fetal rib fractures
d. facial lacerations
e. fetal retinal haemorrhage

17. There are many relative contraindications to the use of vacuum extraction for
delivery it all else is appropriate. What would be an acceptable scenario for
application of a vacuum extractor?
a. non vertex presentation
b. fetal coagulopathies
c. cervix is 9 cm dilation with fetal intolerance of labors
d. fetal prematurity <35 weeks
e. fetal scalp electrode

18. If in that case you found fetal head is at or on perineum with saginal suture is
in anteroposterior diameter or right or left occiput anterior or posterior
position and when you choose forcep delivery, it call as
a. Bullet foceps
b. Low forceps
c. Mid forceps
d. High forceps
e. Very- high forceps
Women 25 years old was reffered to you with complain of early gravida with
vaginal spotting ang miniman lower abdominal pain. Vital sign Bp 100/70 pulse
90x/mnts. Hemoglobin was 10 gr/dL. Gynecologic examination revealed 8 weeks
of uterine size and tenderness in right adnexa.

19. If the result of transvaginal USG could not confirm location of the gestasional
sac. Next step is....
a. Dilatation and curretage
b. Diagniostic laparoscopy
c. Serial evaluation of ultrasonography
d. Culddocentesl
e. Serum hCG evaluation
20. The precusors of Estriol is :
a. Testosterone
b. Pregnenolone
c. Androstenedrone
d. LDI cholesterol
e. DHEAS

21. The major source of estrogens in the human fetus is :

a. The fetal ovary
b. The fetal testis
c. The fetal zone of the adrenal cortex
d. The devinitive zone of the adrenal cortex
e. The placenta

G2P1A0, 28 years old, referred from primary health care with reduce fetal
movement Unable to recall her last menstrual period. the fundal height is 35 cm.
No contraction and no history of amniotic fluid leakage. Her first child was born
mentally with 3500 grams of birth weight
22. Initial assesment for this patient is
a. Fetal biophysical profile
b. Amniocentesis
c. Bishop’s score
d. Countinous fetal heart monitoring
e. Measurement of pelvic inlet

23. Initial assesment reveal that mother and fetus are in good condition As the
health care provider, medical suggestion for thus patient is :
a. Cesarean section
b. Labor induction
c. Observation
d. Assisted delivery
e. Give lung maturation
24. After thorough examination. Bishop score is 4. The next step to do is :
a. Augmentation
b. Cesarean section
c. Vacuum extraction
d. Cervical ripening
e. Forceps extraction

G3P2A0. 32 yean old referred from primary health care with term pregnancy and
pint cesarean section She has a history of cesarean delivery of her first child due
to placenta previa

25. Factors affecting the likelihood of succcessful trial of labor in this patient is :
a. Prior cesarean for malpresentation
b. Spontaneous labor with advanced cervical dilatation on admission
c. Prior vaginal delivery
d. Increase maternal age
e. Recurrent indication lot initial cesarean delivery
26. Twins to twins transfusion syndrome which statement is true :
a. The donor twin develops polyhydramnion
b. Gross different may he observed betwen donor and recipent placentas
c. The donor twin usually have a greater urinary bladder
d. The donor twin more likely develop thromboses
e. The donor twin often develops polycythemia

27. The etiology of chronic twin-to-twin transfusion syndrome :?

a. Is based on the dizygot nature of the conceptus
b. Is undoubtedly due to the associated reversed arterial perfusion sequence
in the acardiac twins.
c. Produce hypovolemia anemia in the recipient ami hypervolemia
polycythemia in the donor
d. Is based on imbalance arterial to venous anastomotic connect mho
between the twins in the placenta
e. Unbalanced placental perfusion of each twin
MRS St , 30 th . G1P0, pregnant 36 weeks, since yesterday experienced shortness
of breath He went to the midwife ami found T : 120 HO . pulse 100 mn . 36
breath / min He was refered to your place. In the physical examination he was
found packed in a sorting condition Fetal head presentation DJJ 140 / mn. Hits (-),
the estimated weight -2300 g. Then you find awereness compost mentis, coarse
breath sounds . wheezing (+) expiratory elongated smooth rough rhonki
throughout the lungs. Pure heart rate, heart is not enlarged. Is your diagnosis and
therapy given

28. What is the patofisiologi of the disease above:

a. viral infection
b. bacterial infection
c. is a chronic inflammatory airway syndrome with a major hereditary
component
d. Infection of the large airways is manifest by cough
 e. have been associated with genes on chromosomes 7q
29. What should we monitored for the risk of respiratory failure
a. FEVI < 35%
b. PO2 increased
c. PCO2 alkalosis
d. FEV 50-60%
e. PCO2 normal

30. The management for this patient, except a patient, except

a. Patient education
b. Avoidance environmental
c. pulmonary therapy
d. Objective assessment of pulmonary function ami fetal wellbeing
e. Infection controlled

31. The frequent complication in the case above, except :

a. Gestasional hypertension
b. Pretern delivery
c. Septic condition
d. Pretern rupture of amniotic membrane
e. Respitory failure

A 28 years old women G2P1 week pregnancy, comes to your clinic to do her
antenatal care and bring laboratory screening result. From complete blood count
find Hb 10.0 g/dl, Ht 30 MCV 78, MCH 28 MCHC 30

32. What in your initial next management?

a. Check feritin
b. Check serum iron
c. Check blood smear
d. Check red distribution width (RDW)
 e. Give iron therapy directly for therapy and also for diagnosis
33. Physiologically anemia during pregnancy is caused by :
a. Inadequate dietary intake
b. Increased cardiac output
c. Decreased blood volume
d. Increased plasma volume
e. Decreased red blood cell volume

From blood smear find microcytic hypochromic. Ferritin level is 11

34. What is the most likely diagnosis of the patient?

a. Thalassemia
b. Iron depletion
c. Hemolytic anemia
d. Iron deficiency anemia
e. Philological anemia in pregnancy

A 16 year-old woman at 33 weeks gestation is referred with high blood pressures

of 190/100 and 3+ proteinuria The patient complains severe headache and blurred
vixion. She does not have any past medical history
35. What is the most likely diagnosis in this patient?
a. Mild preeclampsia
b. Severe preeclampsia
c. Impending preeclampsia
d. Gestational hypertension
e. Super imposed preeclampsia

36. What is the appropriate nest management to this patient?

a. Deliver the baby immediately
b. Gives magnesium sulphate
c. Expectant management until 34 completed weeks
d. Gives lung maturation with dexamethasone for 2 days
 e. Gives antioxidant to miner stress oxidative occurred in this case
37. What is not recommended ahnthypertension drug in pregnancy, considering
this drug can cause renal failure and patent ductus arteriosus in the newborn?
a. Atenolol
b. Captopril
c. Nifedipine
d. Hydralazine
e. Methyldopa

A 28 year old. G2P1, 26 weeks gestation, comet to your policlinic to base

information regarding her current pregnancy. Her previous pregnancy terminated
at weeks gestational age due to intrauterine fetal death Horn female baby. 2500 g
She did antenatal care in hospital, ultrasound examination was done 2x and no
remarkable abnormalities were found. She never did laboratory examination
during her previous pregnancy, Her mother has diabetes mellitus BMI of the
patient is 28

38. The most probable cause of intrauterine fetal death in her previous pregnancy
is?
a. infections
b. Diabetes mellitus
c. Congenital anomaly
d. Rhesus incompatibility
e. Fetal growth restriction

She comes to you 1 week later, and brings laboratory result: Hb 12.1 g/dL Ht 35
Leu 8100. Platelet 265.000 Erythrocyte 4 million MCV 86; MCH 34; MCHC 32;
OGTT (100g) 93/165/160/140. HbAlC 5.6

39. What is diagnosis of the patient?

a. Overt diabetes
b. Type II diabetes
c. Gestational diabetes
 d. Pre-gestational diabetes
e. Laboratory results arc normal
40. What is the most appropriate to this patient ?
a. Insulin
b. Exercise
c. Metformin
d. Nutrition therapy
e. No spesifik treatment

41. NSAIDs affect myometrial activity through which of the following action ?
a. PLA2 activation to create relaxation
b. PG isomerase inhibition to create contraction
c. 15 hydroxy prostaglandine dehydrogenase activation to create contraction
d. PG synthase inhibition to create relaxation
e. IL-6 activation to create contraction

42. Conserning the tyroid gland during pregnancy, which of the following is true?
a. It undergoes enlargement through hyoerthropy
b. Free T4 increases its meas value by term
c. Total T4 increases shaprly between 6 – 9 weeks of gestation
d. hCG which mimics TSH has declining levels beginning at approximately
20 weeks
e. the volume of throid gland is decreases during pregnancy
43. Ninety percent of surfactant is consist of the following?
a. Lipid
b. Protein
c. Carbohydrate
d. Mineral
e. Water

44. Uteroplacental blood flow at term measures approximately which of the

following?
 a. 50 – 100 ml/min
b. 100 – 300 ml/min
c. 700 – 900 ml/min
d. 1000 – 1200 ml/min
e. 1200 – 1400 ml/min

45. Which of the following immunoglobulin crossed the placenta in large

amount?
a. IgA
b. IgE
c. IgM
d. IgG
e. None of the above

46. The phenomenon that describes how fetal cells can become engrafted in the
mother during pregnancy and than be identified decades later is called :
a. Major Histocompatibility Complex (MHC)
b. Hemochorial invasion
c. Microchymerism
d. Human Leucocyte Antigen (HLA)
e. Autograf

47. Which of the following in NOT TRUE regarding of the fetal fibronectin?
a. Is a prognostic indicator of preterm labor
b. Is a Matrix Metallo Proteinases (MMPs)
c. Is also known as “trophoblast Glue”
d. Plays a role in trophblast invasion
e. None of the above

48. Which of the following is mainly overseen regarding of maternal regulation

of trophoblast invasion and vascular growth?
 a. Decidual NK-Cells
b. CDM + TCells
c. Progesterone
d. Cellular Adhesion Molecules
e. VEGF

49. Cardiotopography, Which of the following would be most concerning?

a. Isolated early deceleration
b. Repetitive variable decelerations that resolve quickly after each
contraction
c. Repetitive early decelerations and variable decelerations
d. Repetitive late decelerations and lost of variability
e. Absent decelerations

50. Fetal hemopoesis is first seen in :

a. Bone Marrow
b. Liver
c. Yolk sac
d. Spleen
e. Kidneys

51. Fetal hemoglobin F is produced at which of the following sites?

a. Bone Marrow
b. Liver
c. Yolk sac
d. Spleen
e. Kidneys

52. Which of the fetal activities is the last to develop until 24 weeks of gestation?
a. Opening the mouth
b. Swallowing
 c. Fetal Breathing
d. Sucking
e. Fetal Movement

53. Concerning immunological function during pregnancy which of the following

is true?
a. Th1 response is dominant
b. There is upregulation of T cytotoxic cells
c. Th2 cells are downregulated
d. Decidual NK cells activity are suippressed
e. All of the above

54. What is the mean doubling time for β-hCG during early pregnancy ?
a. 12 h
b. 24 h
c. 48 h
d. 72 h
e. 96 h

55. Excessive supplementation with which of the following is particular concern

as it may be teratogenic?
a. Vitamin A
b. Vitamin B6
c. Vitamin C
d. Vitamin D
e. Vitamin E

56. Sonographic image demonstrates Holoprosencephaly in a 14 weeks fetus.

This finding is most consistenly associated with which chromosomal
abnormality?
a. Mozaicism
 b. Monosomy X
c. Trisomy 13
d. Trisomy 18
e. Trisomy 21

57. If a women has had a prior child with a neural tube defect, what does of folate
is recommended that she should take prior to conception to reduce the
recurrence risk?
a. 400 ug / day
b. 800 ug / day
c. 1 mg / day
d. 4 mg / day
e. None of the above

58. What is the source of the AFP found in maternal serum that is used for
prenatal screening strategis?
a. Amnion
b. Placenta
c. Fetal neural tissue
d. Fetal cerebrospinal fluids
e. Fetal liver and GI tract

59. Which of the following statement regarding Nuchal Transluscency evaluation

is true?
a. It is not effective in multiple gestation
b. Used alone, it detects 80% of Down Syndrome case
c. The highest Down Syndrome detection rate occurs when it is applied as
part of an integrated screen
d. When combined with serum markers in the first trimester it detects 100%
of Down Syndrome cases
e. All of the above
60. Cigarette smoking in pregnancy is linked to an increased risk of which of the
following except?
a. Microcephaly
b. Cleft lip and palate
c. Congenital heart desease
d. Neonatal hyperglycemia
e. IUGR

61. What is the ultimate goal of antepartum fetal surveillance?

a. assessed the fetal health
b. indicate the timing of intervention
c. prevent fetal death
d. improve negative predictive values for antepartum testing
e. All of the above

62. Compared with gastroschisis defect, omphaloceles are more likely to have
which of the following?
a. Involve the fetal liver
b. Be associated with ancuplotdy
c. Be a component of genetic syndrome
d. None of the above
e. All of the above

63. It cystic hygromas are diagnosed in the first trimester, what is the most
commonly associated ancuploidy ?
a. Monosomy X
b. Trisomi 21
c. Trisomi 18
d. Trisomi 13
e. None of the above

64. The most common cause of neonatal hydronephrosis is :

 a. Uretcropelvic junction obstruction
b. Collecting system duplication
c. Ureterovesical junction obstruction
d. Bladder outlet obstruction
e. Urethral agenesis
65. The umbilical artery systolic to diastolic ratio ( SD ratio ) changes in what
way throughout pregnancy ?
a. It increases with advancing gestation
b. It remains approximately constant
c. It decreases with advancing gestation
d. It follows variable and unpredictable pattern,
e. All of the above

66. Middle cerebral artery velocimetry ts most useful as an adjunct to sonography

in which clinical situation ?
a. Fetal growth restriction
b. Intracranial anomaly
c. Hypoxic ischemic encephalopathy
d. Suspected fetal anemia
e. All of the above

67. Which of the following presentations and positions would be most favorable
to achieve a vaginal delivery?
a. Breech
b. Transverse
c. Venex with occiput posterior
d. Venex with occiput anterior
e. Venex with occiput transverse

68. Which of the following is true about fetal scalp blood sampling?
a. It is associated w uh decreased cesarean delivery rate
b. If the scalp pH ti below 7.20. another scalp blood sample is collected
 immediately and the mother is moved to operating theater and prepared
for CS
c. It is commonly employed as an adjunct to continuous fetal monitoring
d. It is advantageous over lactate sampling becaused of a higher procedural
success rate
e. It is possible to perforate transabdonormaly
69. Amnion fusion is associated with which of the following?
a. No change in FHR pattern
b. Decreased meconcum aspiration syndrome rate
c. Increased cesarean delis cry rate
d. Decrease cesarean delivery rate
e. No differences in overall cesarean delivery rate, delivery for fetal distress
when amnioinfusion done for prophylaxis in cases of oligohydramnios

70. Pain during the actual birthing process is derived primarily from which of the
following ?
a. Isehial nerve
b. Hypogastric nerve
c. Pudendal nerve
d. Frankenhauser ganglion
e. All of the above

71. Of the following regional anesthetics, which is the most likely to provide
adequate pain relief for the entire duration of labor ?
a. Paracervical block
b. Pudendal block
c. Spinal block
d. Epidural block
e. Subarachnoid hlsack ( SAB)

72. Postdural puncture headache is most common with which of the following ?
a. SAB
b. Spinal blockade
 c. Epidural anesthesia
d. Combine spinal-epidural
e. All of the above

73. Following cesarean delivery, what is the minimum period a patient should
wail to become premium again to reduce the risk of uterine rapture in that
pregnancy ?
a. 3 months
b. 6 months
c. 1 year
d. 2 year
e. 3 year

74. Which route of bacterial contamination causes most cases of

chorioamnionitis?
a. Ascendence from the lower reproductive tract
b. Direct spread through the fallopian tube
c. Hematogenous spread from maternal blood
d. Needle inoculation during intraamniotic procedures
e. All of the above

75. Which of the following risk factor is most commonly associated with
chorioamnionitis?
a. Maternal drug abuse
b. Coitus during second trimester of pregnancy
c. Prolonged rupture of the membrane
d. Poor maternal hiegene
e. Prior cesarean delivery

76. What is the effect of blood or meconeum contamination of the amniotic fluid
on the L/S ratio?
 a. The contamination increase it
b. The contamination decrease it
c. The contamination cause no change on L/S ratio
d. The effect depend on the amount of contamination
e. None of the above

77. The ACOG recommends antenatal corticosteroid therapy for women at risk
for preterm delivery at what gestation age?
a. 24-34 weeks
b. 20-30 weeks
c. 22-32 weeks
d. 26-36 weeks
e. 20-36 weeks
78. An indication lor early delivery is identified but first test for fetal lung
maturity is done. Which of the following is true?
a. Type I pneumocytes secrete surfactant
b. Lecithin to sphingomyelin (L/S) ratio greater than 2 is deal if an early
delivery is indicated
c. Low L/S rutin is associated with fewer eases of respiratory distress
syndrome (RDS)
d. Typically lecithin decreases as the lung matures
e. Sphingomyelin decreases beyond 2-1 weeks

79. Which of the following is the most accurate way to confirm postterm
pregnancy?
a. Serial sonography performed at ≤ 12 weeks
b. Sonography performed at . 16 – 24 weeks
c. Sonography performed at > 24 – 36 weeks
d. The first fetal quickening told by the mother
e. Last menstrual periode (LMP)
80. Which of the following may be associated placental dysfuction?
a. Increased placental apoptosis
b. Increased cord blood crythropoietin
c. Postmaturity syndrome
d. Oligohydramnios
e. All of the above
81. Which of the following is the most common type of vascular anastomosis
seen in monochorionic twin ?
a. Deep artery-vein anastomosis
b. Deep artery - artery anastomosis
c. Superficial artery-vein anastomosis
d. Superficial artery -artery anastomosis
e. Superficial vein-win anastomosis

82. Which of the following is associated with highest number o! cord

complication?
a. Monoamniotic monochorionic twins
b. Placenta previa
c. Diamniotic dichorionic twins
d. Placenta accreta
e. Placenta circumvalata

83. What is the following morbidity and mortality that NO I related to twins
pregnancy?
a. Preeclampsia
b. Placental abruption
c. Postpartum hemorrhage
d. Acute fatty liver
e. Gestational diabetes

84. The following statements were true according twins pregnancy:

a. Monozygotic twinning more present than dizygotic
 b. Monochorionic more present than dichorionic
c. Monozygotic and Monochorionic twins were associated with
increasing perinatal morbidity and mortality
d. Twin to twin transfusion more frequent in Monochorionic twins
e. no increase risk on maternal complication

85. The following condition is NOT associated with risk factor of Neural tube
defect :
a. First pregnancy
b. Obesity
c. High temperature exposure
d. History of Neural lube defects
e. Anti-set/lire medication