Answers to the CME Quiz for “Prediction and Prevention of Recurrent Stillbirth” by Uma M. Reddy, MD, MPH (Obstet Gynecol 2007;110:1151-64)

1. Following a stillbirth, the relative risk is highest for which of the following complications in a subsequent pregnancy?

A. Placental abruption

2. The largest category of conditions associated with stillbirth is:

B. Fetal growth restriction

3. The recurrence risk of stillbirth in the subsequent pregnancy is:

C. Increased threefold for black women compared to white women

4. A woman has a stillborn infant at 36 weeks of gestation during her first pregnancy. The most likely outcome for her next pregnancy is:

E. Normal term delivery

5. A woman has a stillborn infant at 36 weeks of gestation during her first pregnancy. During her second pregnancy she undergoes a first trimester test of her pregnancy-associated plasma protein A (PAPP-A) that is reported to be below the 5th percentile. This patient’s risk of a stillbirth due to placental dysfunction during this pregnancy is approximately:

A. 2%

6. In the absence of a fetal neural tube or ventral wall defect, the finding of elevated maternal serum alpha fetoprotein (MSAFP) is thought to reflect:

B. Abnormal placentation

7. Which of the following characterizes the changes that uterine spiral arteries undergo to support normal placentation?

C. Low resistance, high compliance

8. When evaluating a growth restricted fetus, which of the following will indicate declining fetal status first?

A. Umbilical Doppler studies

9. In otherwise healthy women with a history of a prior stillbirth, antenatal testing should be begun at approximately:

C. 32–34 weeks

10. The use of first- and second-trimester serum analytes to predict the risk of stillbirth is significantly limited by:

E. Poor predictive value

ACCME Accreditation: The American College of Obstetricians and Gynecologists (ACOG) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. (Continuing medical education credit for “Prediction and Prevention of Recurrent Stillbirth” will be available through November 2010.)

AMA PRA Category 1 Credit^TM and ACOG Cognate Credit: The American College of Obstetricians and Gynecologists (ACOG) designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits^TM or up to a maximum of 2 Category 1 ACOG cognate credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Statement: Current guidelines state that continuing medical education (CME) providers must ensure that CME activities are free from the control of any commercial interest. All authors, reviewers, and contributors have disclosed to ACOG all relevant financial relationships with any commercial interests. The authors, reviewers, and contributors declare that neither they nor any business associate nor any member of their immediate families has financial interest or other relationships with any manufacturer of products or any providers of services discussed in this program. Any conflicts have been resolved through group and outside review of all content.

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