MMBRACE (Platinum) – MCQ

1. What is current overall maternal death rate in UK ?

A. 8.6/ 100000 maternities
B. 9.16/ 100000 maternities
C. 7.16/ 100000 maternities
D. 9.12/ 100000 maternities
E. 6.10/100000 maternities

2. Which of the following is most common cause of direct maternal death occurring within a year after end of pregnancy?

A. Malignancy
B. VTE
C. Cardiac disease
D. Suicide
E. Haemorrhage

3. What is percentage of indirect maternal deaths contributing to overall maternal deaths in UK?

A. 56%
B. 68%
C. 58%
D. 48%
E. 36%

4. what does MBRRACE stands for

A. Mothers and Babies Racing Risk through Audit and Enquiries.
B. Mothers Reducing Risk through Audit and Confidential Enquiries.
C. Mothers and Babies Reducing Risk through Actions and Confidential Enquiries.
D. Mothers and Babies Reducing Risk through Audit and Confidential Enquiries.
E. None of the above

5. All are red flag symptoms of chest pain except

A. mrs, x at 32 weeks hypertensive presenting with sudden onset pain, tearing or exertion all chest pain
B. mrs.z, morbidly obese pregnant women presenting pain radiating to arms, shoulder or jaw
C. Mrs,c, hypertensive , diabetic post cesarean chest pain pain Requiring opioids
D. Mrs, G Ehlers Danlos syndrome (vEDS, EDS IV chest pain , Associated with Breathlessness , syncope
E. Mrs, F, Postpartum complains of back ache , from few days with normal observations relieved with NSAIDS Correct answer is

6. Major potion of deaths in Uk according to according to MBRRACE (2015-17), UK and Ireland is because of

A. Indirect maternal deaths
B. direct maternal deaths
C. Accidental maternal deaths
D. Incidental maternal deaths
E. None of the above

7. According to MBRRACE (2015-17), UK and Ireland largest Single cause of indirect maternal death is because of Cardiac diseases.
What’s the most common cause of cardiovascular death?

A. Arrhythmia
B. Aortic Dissection
C. Valvular heart disease
D. Ischemic deaths
E. Myocardial disease

8. Which of the following is second most common cause of direct maternal deaths in UK?

A. Thromboembolism
B. Cardiac disease
C. Suicide
D. Neurological causes
E. Malignancy

9. Malignancy contributes to the following category of maternal death?

A. Direct maternal deaths
B. Indirect maternal deaths
C. Early maternal deaths
D. Late maternal deaths
E. Co-incidental maternal deaths

10. All of the following are RED FLAG SIGNS of chest pain which are associated with cardiac disease?

A. Pain requiring opioids
B. Pain radiating to arm, shoulder, back or jaw
C. Sudden onset, tearing or exertional chest pain
D. But no haemoptysis
E. Breathlessness, syncope or abnormal neurology

11. Risk of Aortic Dissection is increased how much in pregnant lady?

A. 15 fold
B. 25 fold
C. 35 fold
D. 20 fold
E. 45 fold

12. Risk of Aortic dissection is highest?

A. Second trimester
B. First trimester
C. Third trimester
D. Postpartum
E. Both third trimester and post partum

13. What is current perinatal mortality rate in UK?

A. 2.64 per 1,000 total births for babies born at 24+0 weeks gestational age or later
B. 5.64 per 1,000 total births for babies born at 24+0 weeks gestational age or later
C. 5.16 per 1,000 total births for babies born at 24+0 weeks gestational age or later
D. 5.40 per 1,000 total births for babies born at 24+0 weeks gestational age or later
E. 4.94 per 1,000 total births for babies born at 24+0 weeks gestational age or later

14. What is current Still birth rate in UK?

A. 3.74 per 1,000 total births
B. 3.54 per 1,000 total births
C. 4.2 per 1,000 total births
D. 4.4 per 1,000 total births
E. 3.76 per 1,000 total births

15. What is the current Neonatal Mortality Rate in UK?

A. 1.84 deaths per 1,000 live births.
B. 1.67 deaths per 1,000 live births.
C. 3.84 deaths per 1,000 live births.
D. 2.34 deaths per 1,000 live births.
E. 1.64 deaths per 1,000 live births.

16. Any death related to Ovarian Hyper stimulation Syndrome (OHSS), in UK must be reported to:

A. MBRRACE-UK.
B. RCOG
C. NICE .
D. FIGO
E. HFEA

17. What is the most common cardiac cause of late maternal death in the UK in the latest MBRRACE report of UK?

A. IHD
B. Aortic dissection
C. Myocardial disease/ Cardiomyopathy
D. Mitral valve thrombosis
E. Sudden arrhythmic cardiac deaths with a morphologically normal heart Key C

18. You have just reviewed the MBRRACE-UK 2015–2017 report. What is the rate of amniotic fluid embolism?

A. 0.26 /100 000.
B. 0.87/100 000.
C. 0.97/100 000.
D. 1/100 000.
E. 1.02/100 000.

19. In the recent the UK” (MBRRACE-UK) report, it was recommended that all women with medical disorders in pregnancy should have access to a coordinated multidisciplinary obstetric and medical clinic, thereby avoiding the need to attend multiple appointments and poor communication between senior specialists responsible for their care.

For women with pre-existing medical conditions, the ideal time for planning multidisciplinary care in pregnancy is:

A. First trimester before confirmation of fetal viability
B. Pre-pregnancy
C. First trimester after confirmation of fetal viability
D. Second trimester after screening for lethal fetal anomalies
E. Third trimester prior to confinement for delivery

20. You have just briefed your juniors of the WHO maternal mortality reports.
What is the leading cause of maternal mortality worldwide?

A. Amniotic fluid embolism.
B. Haemorrhage.
C. Sepsis.
D. Thromboembolism.
E. Uterine rupture

21. You are teaching students regarding maternal death. The World Health Organization (WHO) defines indirect maternal death as that resulting from:

A. New disease developed during the pregnancy and not the result of direct obstetric causes but aggravated by the physiological effects of pregnancy.
B. Previous existing disease only and not the result of direct obstetric causes but aggravated by the physiological effects of pregnancy.
C. Previous existing disease or developed during the pregnancy and further com- plicated by direct obstetric labour complications.
D. Previous existing disease or developed during the pregnancy and not the result of direct obstetric causes but aggravated by the physiological effects of pregnancy.
E. Previous existing disease or developed during the pregnancy and which occur in the puerperium.

22. In the 2020 MBRRACE-UK report into maternal deaths, in the years 2015 –2017 , 99 women died before completion of 24 weeks. What was the percentage of deaths due to ectopic pregnancy?

A. 2%.
B. 3.2%.
C. 4.8%.
D. 6.4%.
E. 7.4%.

23. Which statement is true regarding the trends in incidence of direct maternal deaths? (With regard to the MBRRACE-UK report).

A. Direct maternal deaths have not fallen as expected.
B. Direct maternal deaths have fallen every year since 2004.
C. Direct maternal deaths have fallen every year since 1985.
D. Direct maternal deaths have fallen every three years since 1980.
E. The statistically non-significant decrease in direct maternal deaths is predominantly due to a decrease in maternal deaths from haemorrhage and amniotic fluid embolism.

24. You are called to the accident and emergency department to attend to a woman who is 28 weeks pregnant and has just had a cardiac arrest. She requires a perimortem Caesarean section. What is the most essential piece of equipment to start this surgery?

A. Cord clamps.
B. Scalpel.
C. Cutting diathermy.
D. Doyen retractor.
E. Suction.

25. You are giving lecture to student midwives on the topic of maternal mortality.
What is your explanation for the most likely cause of maternal deaths secondary to anaesthesia?

A. Anaphylaxis to anaesthetic drugs.
B. Underestimation of maternal blood loss.
C. Local anaesthetic toxicity.
D. Sepsis secondary to epidural abscess.
E. Failure to secure adequate airway with general anaesthesia.