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Here's the complete chapter-wise breakdown of all 100 Paper 2 questions (Dec 2018 – Dec 2022):

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Paper2 Chapterwise Topics

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Chapter-wise Summary

#	Chapter	Questions
1	Antepartum Fetal Surveillance & Fetal Wellbeing	6
2	Prenatal Diagnosis & Screening	1
3	Preterm Labour & Prematurity	5
4	Hypertensive Disorders of Pregnancy	2
5	Antepartum Haemorrhage (Placenta Previa, Abruption, PAS)	6
6	Medical Disorders in Pregnancy	23
7	Rh Isoimmunization	1
8	Twin & Multiple Pregnancy	11
9	Fetal Growth Restriction & SGA	2
10	Normal & Abnormal Labour	18
11	Caesarean Section	5
12	Postpartum Haemorrhage & Third Stage Complications	6
13	Puerperal Complications	1
14	Neonatology	6
15	Gestational Trophoblastic Disease	1
16	Ectopic Pregnancy	1
17	Abortion & MTP	2
18	External Cephalic Version	1
19	Contraception & Family Planning	1
20	Preconception Counselling & Antenatal Care	1
21	Community Obstetrics & Public Health	1
	TOTAL	100

High-yield chapters to focus on:

Medical Disorders in Pregnancy (23 Qs) — Diabetes, Heart disease, HIV, Hepatitis, Epilepsy, Thyroid, Cholestasis, AFLP
Normal & Abnormal Labour (18 Qs) — Induction, Breech, Shoulder dystocia, VBAC, Rupture uterus
Twin & Multiple Pregnancy (11 Qs) — TTTS, Chorionicity, Hydrops, Monochorionic complications
Antepartum Haemorrhage (6 Qs) — Placenta Accreta Spectrum asked repeatedly
Neonatology (6 Qs) — Sepsis, Jaundice, Resuscitation, Essential newborn care

What the these questions? I can’t download

Here are all 100 Paper 2 questions, organized chapter-wise:

PAPER 2 — CHAPTER-WISE QUESTIONS

(Dec 2018 – Dec 2022)

Chapter 1: Antepartum Fetal Surveillance & Fetal Wellbeing

(6 Questions)

Q1. [Dec2022 – Q2] a) Describe various methods of antepartum fetal screening. [3] b) Discuss non-invasive techniques for prenatal diagnosis. [7]

Q2. [Dec2022 – Q10] a) Discuss diagnosis and management of a primigravida patient with 41+2 weeks of gestational age not in labour. [10]

Q3. [June2022 – Q10] Gravida 2 para 1 at 38 weeks with previous caesarean scar has presented with loss of fetal movements: a) List the causes of decreased fetal movements. [3] b) Discuss investigations you would order. [3] c) How will you manage this patient? [4]

Q4. [Aug2021 – Q1] a) What are the causes of decreased fetal movements in the third trimester of pregnancy? [2] b) Discuss the management of a patient presenting with decreased fetal movements at 36 weeks. [8]

Q5. [June2018 – Q7] a) What are the various modalities of intrapartum fetal surveillance in high risk pregnancy? [5] b) Role of intrauterine resuscitation in non-reassuring fetal status. [5]

Q6. [June2018 – Q10] An unbooked primigravida at 32 weeks presents with intrauterine fetal demise (IUFD): a) Enumerate the causes of IUFD. [4] b) Discuss the management and counselling of the case. [6]

Chapter 2: Prenatal Diagnosis & Screening

(1 Question)

Q1. [June2019 – Q3] a) Methods for assessment of gestational age. [5] b) What are the indices of foetal maturity? [5]

Chapter 3: Preterm Labour & Prematurity

(5 Questions)

Q1. [Dec2022 – Q9] a) Discuss etiopathology and diagnosis of incompetent cervix and types of cerclage. [6] b) Describe management of cervical incompetence. [4]

Q2. [June2022 – Q8] a) Role of antenatal corticosteroid therapy – advantages and disadvantages. [5] b) Describe the various drugs, dosage and indications for tocolysis. [5]

Q3. [Aug2021 – Q2] a) What are the causes of early neonatal death in preterm neonates? [2] b) Discuss the management of a 30-year-old G3P2 with preterm labour at 30 weeks. [8]

Q4. [Dec2020 – Q8] a) Apgar score. [5] b) Antenatal corticosteroids. [5]

Q5. [June2018 – Q5] a) What are the risk factors for prematurity? [2] b) Describe the complications of prematurity. [4] c) What are the interventions to improve outcome in preterm neonates? [4]

Chapter 4: Hypertensive Disorders of Pregnancy

(2 Questions)

Q1. [Dec2020 – Q4] a) Define preeclampsia. [3] b) How will you manage a case of primigravida at 34 weeks with eclampsia? [7]

Q2. [Dec2019 – Q2] a) How will you classify and define hypertensive disorders of pregnancy? [5] b) Role of anti-hypertensives in pre-eclampsia. [5]

Chapter 5: Antepartum Haemorrhage

(6 Questions)

Q1. [Dec2022 – Q3] a) Describe the Nitabuch's layer. [1] b) Describe the diagnosis of PAS (Placenta Accreta Spectrum). [4] c) Discuss management of PAS. [5]

Q2. [Dec2021 – Q7] a) Discuss the etiology and classification of placenta previa. [2+2] b) Discuss the management of a third gravida with painless bleeding at 32 weeks with placenta previa. [6]

Q3. [June2020 – Q2] a) Enumerate the etiology of abruptio placentae. [4] b) How will you manage a case of abruptio placentae? [6]

Q4. [June2020 – Q6] a) What is Placenta Accreta Syndrome (PAS)? [2] b) What are risk factors for PAS? [2] c) How will you diagnose it? [3] d) Discuss management of PAS. [3]

Q5. [June2019 – Q1] a) Mention the predisposing factors for abruptio placentae. [2] b) What is couvelaire uterus? [2] c) Management of abruptio placentae. [6]

Q6. [Dec2019 – Q9] a) Placenta accreta and its diagnosis by imaging. [5] b) Management of a previous caesarean with suspected placenta accreta. [5]

Chapter 6: Medical Disorders in Pregnancy

(23 Questions)

Q1. [Dec2022 – Q1] a) Define physiological skin changes during pregnancy. [2] b) Enumerate etiology of pruritus in pregnancy. [3] c) Discuss management of pruritus in pregnancy. [5]

Q2. [Dec2022 – Q4] What is the basis of WHO risk classification of heart disease in pregnancy? Discuss management of a 23-year-old primigravida at 24 weeks with worsening dyspnoea found to have mitral valve stenosis. [10]

Q3. [Dec2022 – Q5] a) Describe causes of maternal collapse in pregnancy. [4] b) Discuss the approach to maternal collapse. [6]

Q4. [Dec2022 – Q6] a) Describe causes of fever in pregnancy and puerperium. [5] b) Discuss the management of malaria in pregnancy. [5]

Q5. [June2022 – Q1] a) Define thrombocytopenia in pregnancy. [2] b) Write the etiologic classification of thrombocytopenia in pregnancy. [3] c) Discuss management of ITP in pregnancy. [5]

Q6. [June2022 – Q9] a) Describe various antihypertensive drugs in pregnancy including dosage and side effects. [6] b) Describe postpartum management of hypertension. [4]

Q7. [Dec2021 – Q8] Mrs X, a known hypothyroid on thyroxine, is planning pregnancy and comes for preconception counselling. Discuss her management during preconception, antenatal and postnatal periods. [10]

Q8. [Dec2021 – Q9] a) What are safety guidelines for imaging modalities in pregnancy? [3] b) Discuss the goals of National Rural Health Mission. [7]

Q9. [Dec2021 – Q10] Mrs Y, 33 years, G3P2L2 at 12 weeks comes with HIV test positive: a) Discuss management of this case. [7] b) Discuss PMTCT. [3]

Q10. [Aug2021 – Q5] a) Discuss the management of a neonate born to HIV positive woman. [5] b) Early onset neonatal sepsis – diagnosis and prophylaxis. [5]

Q11. [Aug2021 – Q7] a) Define Cholestasis of pregnancy. [2] b) How is Obstetric Cholestasis diagnosed? [3] c) Outline the management of intrahepatic cholestasis of pregnancy. [5]

Q12. [Dec2020 – Q3] a) Enumerate the changes in carbohydrate metabolism during pregnancy. [5] b) How will you manage a case of overt diabetes mellitus in pregnancy? [5]

Q13. [June2020 – Q4] a) What are the course/effects of epilepsy in pregnancy? [4] b) Discuss the common drugs used in pregnancy with epilepsy. [6]

Q14. [June2020 – Q5] a) How will you optimize antenatal care during COVID-19 pandemic? [4] b) Management of suspected/confirmed COVID-19 case in pregnancy. [6]

Q15. [June2020 – Q8] a) Etiopathology of acute fatty liver disease in pregnancy. [4] b) How will you manage such a case? [6]

Q16. [Dec2019 – Q6] a) Acute fatty liver of pregnancy. [5] b) How do you differentiate it from viral hepatitis? [5]

Q17. [Dec2019 – Q10] a) Discuss the different screening methods for gestational diabetes. [2] b) Describe the neonatal complications in infants of diabetic mothers. [8]

Q18. [June2019 – Q4] a) What is the effect of SLE on pregnancy? [2] b) Diagnosis and management of a case of pregnancy with APLA syndrome. [8]

Q19. [June2019 – Q9] a) Causes of jaundice during pregnancy. [2] b) Diagnosis and management of viral hepatitis during pregnancy. [8]

Q20. [Dec2018 – Q7] a) Current national guidelines for antenatal management for prevention of vertical transmission of HIV. [5] b) Management of a HIV-positive woman in labour. [5]

Q21. [Dec2018 – Q9] A young multigravida presents at term with acute onset of severe breathlessness: a) Discuss the differential diagnosis. [4] b) Discuss the management of peripartum cardiomyopathy. [6]

Q22. [Dec2018 – Q10] A 33-year-old woman with type 2 diabetes on oral hypoglycaemic agent presents at 6 weeks: a) Preconception counselling for diabetic women. [3] b) Antenatal management. [4] c) Intrapartum and postpartum management. [3]

Q23. [June2018 – Q4] a) Cardiovascular changes during pregnancy. [4] b) What are the clinical indicators of heart disease in pregnancy? [2] c) Management of a case of mitral stenosis in pregnancy. [4]

Chapter 7: Rh Isoimmunization

(1 Question)

Q1. [June2022 – Q7] a) What is meant by Rh isoimmunized pregnancy? [2] b) Discuss the management options of G2P1 Rh isoimmunized pregnancy at 26 weeks with hydrops on USG. [8]

Chapter 8: Twin & Multiple Pregnancy

(11 Questions)

Q1. [Dec2022 – Q7] a) Enumerate causes of fetal hydrops. [3] b) Discuss diagnosis and management of immune fetal hydrops at 22 weeks gestation. [7]

Q2. [June2022 – Q4] a) Explain the genesis of twin-twin transfusion syndrome (TTTS). [2] b) How to diagnose a case of TTTS? [4] c) Describe management of TTTS. [4]

Q3. [Aug2021 – Q3] a) What is non-immune hydrops foetalis (NIHF)? [2] b) How will you manage a case of NIHF at 26 weeks of gestation, and what is the prognosis? [8]

Q4. [Aug2021 – Q6] a) Explain the genesis of Twin Gestation. [5] b) What are the complications of monochorionic twin pregnancy? [5]

Q5. [June2020 – Q1] a) Quintero staging system of twin-to-twin transfusion syndrome (TTTS). [6] b) Latest management of TTTS. [4]

Q6. [June2020 – Q10] a) What are the different methods to assess chorionicity in pregnancy? [5] b) What are the implications of chorionicity on pregnancy outcome? [5]

Q7. [Dec2019 – Q8] a) What are the different methods to assess chorionicity in pregnancy? [5] b) Discuss the various implications of chorionicity on pregnancy outcome. [5]

Q8. [Dec2018 – Q1] a) Trimester-wise antenatal tests to be offered to a pregnant woman with a previous child having Down syndrome. [5] b) Antenatal management of monochorionic diamniotic (MCDA) twin pregnancy. [5]

Q9. [Dec2018 – Q6] a) What are the different antenatal complications of twin pregnancy? [3] b) Assessment and management after delivery of first twin. [4] c) Management of locked twins. [3]

Q10. [June2018 – Q1] a) Etiopathogenesis of Non-Immune Hydrops in fetus. [5] b) How will you manage a case of Non-Immune Hydrops at 26 weeks, and what is the prognosis? [5]

Q11. [June2018 – Q3] A patient aged 39 years with triplet pregnancy at 6 weeks conceived after IVF: a) Counselling regarding risks in triplet pregnancy. [4] b) Role of fetal reduction. [3] c) Antenatal management of triplet pregnancy. [3]

Chapter 9: Fetal Growth Restriction & SGA

(2 Questions)

Q1. [June2022 – Q5] a) Define small for gestational age (SGA) and its various etiologies. [4] b) Discuss the workup and management of a pregnancy complicated by SGA at 32 weeks. [6]

Q2. [June2018 – Q9] a) Define Fetal Growth Restriction (FGR). [2] b) What are the causes of FGR? [2] c) How will you diagnose and manage a case of FGR at 34 weeks? [6]

Chapter 10: Normal & Abnormal Labour

(18 Questions)

Q1. [Dec2021 – Q1] a) What is WHO Labour Care Guide? [5] b) Describe Cardiotocography. [5]

Q2. [Dec2021 – Q2] a) Discuss the complications of induction of labour and their management. [6] b) Discuss the measures that can be taken to reduce caesarean section rate. [4]

Q3. [Dec2021 – Q4] Mrs X, 34 years, G2P1 with previous LSCS for breech, presents in labour. She was counselled for VBAC: a) What are the prerequisites of VBAC? [3] b) Discuss intrapartum monitoring of VBAC. [4] c) How will you manage scar dehiscence? [3]

Q4. [Dec2020 – Q1] a) Shoulder dystocia. [5] b) Induction of labour. [5]

Q5. [Dec2020 – Q10] a) Methods of delivery of after-coming head in breech presentations. [5] b) Management of neglected shoulder presentation. [5]

Q6. [June2020 – Q3] a) Diagnosis of premature rupture of membranes. [4] b) Management protocol of a primigravida at 30 weeks attending with PPROM. [6]

Q7. [Dec2019 – Q3] a) Management of after-coming head in breech. [5] b) Precautions to be taken in delivery of premature breech. [5]

Q8. [Dec2019 – Q5] a) What is active management of third stage of labour? [5] b) Describe the surgical management of atonic postpartum haemorrhage. [5]

Q9. [June2019 – Q5] a) How will you diagnose shoulder dystocia in labour? [2] b) Complications of shoulder dystocia. [2] c) Management of shoulder dystocia. [6]

Q10. [June2019 – Q6] a) Define trial labour. [2] b) What are the contraindications for trial labour? [2] c) What are the favourable and unfavourable features for trial of scar? [6]

Q11. [June2019 – Q7] a) Define rupture of the uterus. [2] b) Diagnosis and management of uterine rupture. [8]

Q12. [June2022 – Q2] a) Define deep transverse arrest (DTA) and its various etiologies. [4] b) Discuss the management options of DTA. [4] c) Complications of DTA. [2]

Q13. [June2018 – Q8] a) What is the difference between augmentation and induction of labour? [2] b) List the prerequisites of induction of labour. [3] c) Describe the various methods of induction of labour. [5]

Q14. [June2022 – Q6] (Caesarean Scar Pregnancy — also under Ectopic) a) How to diagnose caesarean scar pregnancy? [2] b) Enlist various risk factors for caesarean scar pregnancy. [2] c) Describe management of caesarean scar pregnancy. [6]

Q15. [Dec2020 – Q2] a) Medical management of ectopic pregnancy. [5] b) Caesarean scar pregnancy. [5]

Q16. [Dec2021 – Q6] a) Discuss the indications, contraindications and limitations of medical methods of abortion. [1+2+2] b) Mrs Z, 33 years, presents with 8 weeks pregnancy with previous two LSCS requesting termination. Discuss her management. [5]

Q17. [June2020 – Q5] a) How will you optimize antenatal care during COVID-19 pandemic? [4] b) Management of suspected/confirmed COVID-19 in pregnancy. [6]

Q18. [June2018 – Q2] a) How will you date pregnancy? [5] b) How will you manage a pregnant woman past expected date of delivery? [5]

Chapter 11: Caesarean Section

(5 Questions)

Q1. [Dec2021 – Q3] a) What can be the strategy for reducing caesarean section rate? [3] b) Discuss parenteral iron therapy. [4] c) Write briefly on partograph. [3]

Q2. [Aug2021 – Q4] a) Strategies to reduce caesarean section rates. [5] b) Indicators of maternal, neonatal and child health. [5]

Q3. [Dec2018 – Q2] A 32-year-old primigravida weighing 120 kg (BMI 38 kg/m²) presents at 6 weeks: a) Risks associated with obesity in pregnancy. [4] b) Antenatal management. [3] c) Intrapartum and postpartum management. [3]

Q4. [Dec2018 – Q3] A multigravida with previous LSCS found to have anterior type 3 placenta praevia at 28 weeks: a) Antenatal management. [4] b) Delivery planning. [3] c) Intraoperative and postoperative challenges. [3]

Q5. [Dec2018 – Q8] a) Robson classification for LSCS. [4] b) List the common causes contributing to rising rates of caesarean section. [3] c) Methods to audit and reduce caesarean section rates. [3]

Chapter 12: Postpartum Haemorrhage & Third Stage Complications

(6 Questions)

Q1. [Aug2021 – Q10] a) How will you classify uterine inversion? [2] b) Discuss the management of uterine inversion following vaginal delivery. [8]

Q2. [Dec2020 – Q9] a) Acute inversion of uterus. [5] b) Management of postpartum haemorrhage. [5]

Q3. [Dec2019 – Q5] a) What is active management of third stage of labour? [5] b) Describe the surgical management of atonic postpartum haemorrhage. [5]

Q4. [June2018 – Q6] a) What are the causes of cervical tear during delivery? [3] b) How will you suspect and diagnose a case of cervical tear? [3] c) Management of cervical tear. [4]

Q5. [June2022 – Q3] A 28-year-old para 2 presents 24 hours after vaginal delivery at home with severe sepsis: a) What organisms are commonly responsible? [2] b) Principles of management of puerperal sepsis. [8]

Q6. [Dec2020 – Q5] a) Define puerperal pyrexia. Enumerate the causes of puerperal pyrexia. [5] b) How will you manage a case of puerperal sepsis? [5]

Chapter 13: Puerperal Complications

(1 Question)

Q1. [June2019 – Q10] a) What is puerperal sepsis? [2] b) Predisposing factors for puerperal sepsis. [3] c) Management of puerperal sepsis. [5]

Chapter 14: Neonatology

(6 Questions)

Q1. [Dec2020 – Q6] a) Kangaroo mother care. [5] b) Neonatal resuscitation. [5]

Q2. [Dec2020 – Q7] a) Define and classify neonatal sepsis. [5] b) Outline the management of neonatal sepsis. [5]

Q3. [June2020 – Q7] a) How to differentiate caput succedaneum, subgaleal haematoma and cephalhematoma? [5] b) Causes and management of each of the above. [5]

Q4. [June2020 – Q9] a) Essential newborn care. [4] b) Neonatal jaundice. [3] c) Hypoxic ischaemic encephalopathy. [3]

Q5. [June2019 – Q8] a) Enumerate congenital malformations in newborn which are surgical emergencies. [2] b) Diagnosis and management of tracheo-oesophageal fistula. [8]

Q6. [Dec2018 – Q4] a) Discuss the causes of jaundice in the newborn. [5] b) What is the rationale for phototherapy for neonatal hyperbilirubinaemia? [5]

Chapter 15: Gestational Trophoblastic Disease

(1 Question)

Q1. [Dec2022 – Q8] a) Describe classification of GTD and pathogenesis of gestational trophoblastic diseases. [4] b) Discuss management of persistent trophoblastic disease. [6]

Chapter 16: Ectopic Pregnancy

(1 Question)

Q1. [Dec2018 – Q5] a) What are the different types of ectopic pregnancy? [3] b) Assessment of the patient in emergency. [3] c) Medical management of ectopic pregnancy. [4]

Chapter 17: Abortion & MTP

(2 Questions)

Q1. [Dec2019 – Q1] a) What are the causes of recurrent pregnancy loss? [5] b) Role of low molecular weight heparin in its treatment. [5]

Q2. [June2019 – Q2] a) MTP Act. [4] b) Management of septic abortion. [6]

Chapter 18: External Cephalic Version

(1 Question)

Q1. [Aug2021 – Q9] a) Define external cephalic version. [2] b) What are the prerequisites and complications of ECV? [8]

Chapter 19: Contraception & Family Planning

(1 Question)

Q1. [Dec2021 – Q5] a) Write about transdermal contraceptive patch. [3] b) Describe postpartum contraception. [4] c) Write a note on Ulipristal acetate. [3]

Chapter 20: Preconception Counselling & Antenatal Care

(1 Question)

Q1. [Aug2021 – Q8] a) What is preconception counselling? [2] b) How will you do preconceptional counselling in a 24-year-old nulliparous woman with PCOS? [8]

Chapter 21: Community Obstetrics & Public Health

(1 Question)

Q1. [Dec2019 – Q7] a) ASHA worker. [5] b) Describe her responsibilities. [5]

Total: 100 Questions across 21 Chapters

Most repeated topics: Placenta Accreta Spectrum (4×), TTTS/Chorionicity (4×), Shoulder dystocia (2×), Caesarean section rates (3×), Acute fatty liver (2×), Hydrops fetalis (3×), Induction of labour (3×), HIV in pregnancy (3×), Corticosteroids (2×), Abruptio placentae (2×).

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Chapter 1, Q1 — [Dec 2022 – Q2]

a) Describe various methods of antepartum fetal screening [3 marks] b) Discuss non-invasive techniques for prenatal diagnosis [7 marks]

PART A: Methods of Antepartum Fetal Screening [3 Marks]

Antepartum fetal screening aims to identify fetuses at risk of adverse perinatal outcome before the onset of complications. The methods are broadly divided into:

1. Fetal Movement Assessment

Maternal perception of fetal movements is the simplest screening method
Normal: ≥10 movements in 2 hours (Cardiff count-to-ten method)
Decreased fetal movements → trigger for further investigation
Low cost, non-invasive, continuous monitoring

2. Non-Stress Test (NST) / Cardiotocography (CTG)

Records fetal heart rate (FHR) in relation to fetal movements
Reactive NST (normal): ≥2 accelerations of ≥15 bpm lasting ≥15 seconds in a 20-minute window
Reflects fetal neurological integrity and oxygenation
Performed from 28 weeks; twice weekly in high-risk pregnancies

3. Biophysical Profile (BPP)

Combines ultrasound assessment + NST — 5 parameters, each scored 0 or 2 (max 10):

Parameter	Normal (score 2)
Fetal breathing movements	≥1 episode ≥30 sec in 30 min
Gross body movements	≥3 discrete movements in 30 min
Fetal tone	≥1 episode of extension + return to flexion
Amniotic fluid volume	Deepest vertical pocket (DVP) ≥2 cm
NST	Reactive

Score 8–10 = normal; 6 = equivocal (repeat in 24 hrs); ≤4 = abnormal → deliver
Modified BPP = NST + AFI (amniotic fluid index); quicker and widely used

4. Ultrasound-Based Screening

Fetal growth biometry (BPD, HC, AC, FL) — serial scans every 3–4 weeks from 28 weeks
Amniotic fluid assessment: AFI or DVP
Doppler velocimetry: umbilical artery, middle cerebral artery, ductus venosus

5. Doppler Velocimetry

Umbilical artery Doppler: assesses placental resistance
- Absent end-diastolic flow (AEDF) or reversed end-diastolic flow (REDF) → severe uteroplacental insufficiency → immediate delivery consideration
Middle cerebral artery (MCA) Doppler: brain-sparing effect in FGR; MCA PSV >1.5 MoM → fetal anaemia
Ductus venosus: abnormal waveform (absent/reversed a-wave) → impending fetal acidosis

6. Serum Biochemical Screening

AFP, hCG, uE3, Inhibin A (Quadruple screen, 15–20 weeks) — for neural tube defects and aneuploidy
PAPP-A + free β-hCG (11–13+6 weeks) — first trimester combined screen

PART B: Non-Invasive Techniques for Prenatal Diagnosis [7 Marks]

Prenatal diagnosis refers to identification of fetal conditions (chromosomal, structural, genetic) before birth. Non-invasive techniques carry no procedure-related pregnancy loss risk.

1. Ultrasonography

a) First Trimester Ultrasound (11–13+6 weeks)

Nuchal Translucency (NT) measurement: NT ≥3.5 mm associated with trisomy 21, 18, 13, Turner syndrome, cardiac defects
Nasal bone assessment: absent nasal bone in ~70% of trisomy 21
Ductus venosus and tricuspid regurgitation: soft markers for aneuploidy
Crown-Rump Length (CRL): accurate dating (±3–5 days)

b) Second Trimester Anomaly Scan (18–20 weeks)

Detailed structural survey: head, brain, face, spine, heart (4-chamber view, LVOT, RVOT), abdomen, kidneys, limbs
Detects structural anomalies: neural tube defects, cardiac defects, abdominal wall defects, skeletal dysplasias
Soft markers for aneuploidy: choroid plexus cysts, echogenic bowel, short femur, renal pelviectasis, sandal gap toe, single umbilical artery

c) Fetal Echocardiography (20–24 weeks)

Indicated in: family history of CHD, maternal diabetes, teratogen exposure, fetal arrhythmia
Detects: VSD, TOF, TGA, hypoplastic left heart, etc.

2. Cell-Free Fetal DNA (cfDNA) / Non-Invasive Prenatal Testing (NIPT)

Principle: Fetal DNA (10–15% of total cell-free DNA) from apoptotic placental trophoblasts circulates in maternal blood from ~9–10 weeks
Analysed by next-generation sequencing (NGS) or SNP-based methods

Screening targets:

Target	Detection Rate	False Positive Rate
Trisomy 21 (Down syndrome)	~99.7%	~0.13%
Trisomy 18 (Edwards)	~97.9%	0.13%
Trisomy 13 (Patau)	~99.0%	0.13%
Monosomy X (Turner)	~90%	—
Sex chromosome aneuploidies	Variable	—
Microdeletions (22q11, 15q)	Emerging	—

Timing: From 10 weeks gestation onward Fetal fraction: Minimum 4% required for reliable result Limitations:

Screening test only — NOT diagnostic; positive results must be confirmed by CVS or amniocentesis
Confined placental mosaicism can cause false positives
Cannot detect all chromosomal abnormalities (e.g., balanced translocations, triploidy unreliable)
Higher false positive in low-risk populations (lower PPV)
Cannot replace structural anomaly scan
Vanishing twin can confound results

Indications for cfDNA (ACOG):

AMA (≥35 years)
Positive first/second trimester screen
Prior trisomy pregnancy
Parental Robertsonian translocation
Ultrasound finding suggestive of aneuploidy

3. Maternal Serum Biochemistry

a) First Trimester Combined Screen (11–13+6 weeks)

PAPP-A + free β-hCG + NT + maternal age
Detection rate for trisomy 21: ~85–90% at 5% FPR
Low PAPP-A also associated with FGR, preterm birth, stillbirth

b) Second Trimester Quad Screen (15–20 weeks)

Marker	Trisomy 21	Trisomy 18	Neural Tube Defect
AFP	↓	↓	↑↑
hCG	↑	↓	Normal
uE3	↓	↓	Normal
Inhibin A	↑	Normal	Normal

Detection rate: ~80% for Down syndrome at 5% FPR

c) Integrated/Sequential Screening

Combines first + second trimester markers for highest detection (~95%) with lowest FPR (~1%)

4. Three-Dimensional (3D) and Four-Dimensional (4D) Ultrasound

Enhanced anatomical assessment of face (cleft palate), skeletal anomalies, neural tube defects
4D (real-time 3D): fetal behaviour, limb movement assessment
Does NOT replace standard 2D scan but is complementary

5. Fetal MRI (Non-Invasive but Specialized)

Used when USS is inconclusive — particularly for CNS anomalies (corpus callosum agenesis, posterior fossa malformations, cortical development)
Safe after first trimester; no ionising radiation
No gadolinium contrast in pregnancy

Summary Table: Non-Invasive Techniques

Technique	Timing	What it Detects
NT + nasal bone USS	11–13+6 wks	Aneuploidy, structural defects
Combined screen (PAPP-A + β-hCG + NT)	11–13+6 wks	Aneuploidy risk
Quad screen	15–20 wks	Aneuploidy, NTD
cfDNA / NIPT	≥10 wks	Trisomies, sex chromosome aneuploidies
Anomaly scan	18–20 wks	Structural anomalies
Fetal echo	20–24 wks	Congenital heart defects
3D/4D USS	2nd/3rd trimester	Facial/skeletal anomalies
Fetal MRI	2nd/3rd trimester	CNS anomalies

Key exam point: cfDNA/NIPT has the highest sensitivity and lowest false-positive rate of all Down syndrome screening tests, but it remains a screening — not diagnostic — tool. All screen-positive results must be confirmed by invasive testing (amniocentesis/CVS). (Creasy & Resnik's Maternal-Fetal Medicine)

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Here is the complete chapter-wise list of all 100 Paper 4 questions (Dec 2018 – Dec 2022):

PAPER 4 — CHAPTER-WISE QUESTIONS

(Dec 2018 – Dec 2022 | 100 Questions)

Chapter 1: Prenatal Diagnosis & Genetics

(11 Questions)

Q1. [Dec2022 – Q9] Discuss role of genetic counseling and its effect on management of ovarian cancer. [10]

Q2. [Aug2021 – Q3] a) What is aneuploidy screening? [2] b) Discuss the prenatal screening strategies for diagnosis of fetal aneuploidies. [8]

Q3. [Dec2020 – Q1] a) What is Chromosome microarray analysis? [5] b) What is the clinical application of Chromosome microarray analysis? [5]

Q4. [Dec2020 – Q2] a) What is preimplantation genetic testing and different techniques used for it? [5] b) Clinical applications of preimplantation genetic testing. [5]

Q5. [Dec2020 – Q3] a) How can sonography augment aneuploidy screening? [6] b) Enumerate the soft signs associated with fetal trisomy 21. [4]

Q6. [June2020 – Q3] a) What do you mean by Cell Free DNA? [3] b) Role of Cell Free DNA in Modern Obstetrics. [7]

Q7. [Dec2019 – Q1] a) What is NIPT? [5] b) What is the current role of NIPT? [5]

Q8. [Dec2019 – Q2] a) What is chorionic villus sampling and how is it done? [5] b) Clinical applications of chorionic villus sampling. [5]

Q9. [Dec2019 – Q7] a) What is Pre-implantation Genetic Testing (PGT)? [5] b) Applications in ART. [5]

Q10. [June2019 – Q5] a) Causes of recurrent pregnancy loss. [2] b) Significance of pedigree chart. [2] c) Genetic counselling in recurrent pregnancy loss. [6]

Q11. [Dec2018 – Q1] a) NIPT. [5] b) GeneXpert. [5]

Chapter 2: Assisted Reproductive Technology (ART) & Infertility

(22 Questions)

Q1. [Dec2022 – Q1] Discuss cryopreservation of embryo and oocyte, length of successful preservation and what influences rates of successful pregnancy. [10]

Q2. [Dec2021 – Q4] a) Discuss the complications of ART. [4] b) What are the long-term and short-term outcomes in children born after assisted reproductive technology? [6]

Q3. [Dec2021 – Q5] a) Discuss indications and methods of female fertility preservation. [6] b) Discuss the various methods of improving the quality of oocytes. [4]

Q4. [Dec2021 – Q9] a) Discuss management of luteal phase defect. [5] b) Discuss indications and drugs used in menopausal hormone therapy. [5]

Q5. [Dec2021 – Q10] a) Discuss the diagnostic criteria for PCOS and role of inositol in management of PCOS. [3+2] b) Discuss the role of GnRH analogue in ART cycles. [5]

Q6. [Aug2021 – Q2] a) Enumerate indications of oocyte cryopreservation. [2] b) How do you manage a woman who has conceived following Assisted Reproductive Technology? [8]

Q7. [Dec2020 – Q6] a) Ovarian tissue cryopreservation. [5] b) Role of PET-CT in gynaecology. [5]

Q8. [Dec2020 – Q10] a) What are the strategies to limit the multiple gestation risk of assisted reproductive technology? [5] b) Fetal reduction. [5]

Q9. [June2020 – Q1] a) Ovarian Hyperstimulation Syndrome. [5] b) Interpretation and management of abnormal semen report. [5]

Q10. [June2020 – Q5] a) Indicators of ovarian reserve. [4] b) Challenges and precautions during laparoscopic cystectomy of bilateral large endometriomas in an infertile woman. [6]

Q11. [June2020 – Q6] a) Indications and challenges of elective single embryo transfer (eSET). [5] b) Role of imaging in adenomyosis. [5]

Q12. [Dec2019 – Q9] a) Describe the different markers of ovarian reserve. [5] b) What are the indications for IVF-ICSI? [5]

Q13. [June2019 – Q2] a) Define azoospermia. [2] b) Types of azoospermia. [2] c) Sperm retrieval techniques. [6]

Q14. [June2019 – Q3] a) What is LH surge? [2] b) Functions of LH surge. [2] c) Indications of surrogate LH surge. [2] d) Methods of ovulation trigger. [4]

Q15. [June2019 – Q10] a) Uterotubal peritoneal factors for infertile women. [2] b) Role of hysteroscopic surgery in infertility. [8]

Q16. [Dec2018 – Q4] a) Selective progesterone receptor modulators. [5] b) Prediction of ovarian reserve. [5]

Q17. [June2018 – Q2] a) What is ART? [2] b) What are different components of IVF cycle? [4] c) How can you prevent Ovarian Hyper Stimulation Syndrome (OHSS)? [4]

Q18. [June2018 – Q9] a) Define unexplained infertility. [2] b) Discuss the role of laparohysteroscopy in women with unexplained infertility. [4] c) How will you manage unexplained infertility? [4]

Q19. [Dec2021 – Q3] (Lethal fetal anomalies — ART context) a) Discuss the antepartum and intrapartum care of pregnancy complicated by lethal fetal anomalies. [4] b) Discuss the diagnosis and management of fetal macrosomia. [6]

Q20. [June2022 – Q7] a) Describe the role of ferric carboxymaltose in treatment of anaemia in pregnancy and postpartum. [2] b) How to differentiate between iron deficiency anaemia and thalassaemia trait? [4] c) Management of thalassaemia in pregnancy. [4]

Q21. [Aug2021 – Q6] a) Define Partogram. [2] b) Discuss the New Labour Care Guidelines of WHO 2020. [8]

Q22. [Dec2018 – Q7] a) Role of biomarkers in prediction of pre-eclampsia. [5] b) Current guidelines for the antibiotic prophylaxis in pregnant women with preterm prelabour rupture of membranes. [5]

Chapter 3: Fetal Therapy & Invasive Procedures

(6 Questions)

Q1. [June2022 – Q6] a) Describe various in-utero intrafetal therapy – indications and procedures. [4] b) Enlist various complications related to in-utero intrafetal therapy. [6]

Q2. [June2022 – Q9] a) Uterus transplant: indications and future perspectives. [5] b) Discuss the uses and recommendations for umbilical cord banking. [5]

Q3. [Aug2021 – Q5] a) Define foetal therapy. [2] b) Discuss the principles, indications and categorization of fetal therapy. [8]

Q4. [Dec2020 – Q4] a) What are the different methods of fetal therapy? [7] b) Describe EXIT surgery. [3]

Q5. [June2020 – Q7] a) Define fetal blood sampling (FBS) and enumerate its indications. [4] b) Sites and complications of FBS. [6]

Q6. [Dec2019 – Q4] a) What are the different methods of fetal therapy? [7] b) Describe the EXIT surgery. [3]

Chapter 4: Endometriosis

(5 Questions)

Q1. [Dec2022 – Q10] a) Describe classification of endometriosis. [4] b) Discuss non-invasive diagnosis of endometriosis. [3] c) Treatment of a 32-year-old woman with endometriosis and infertility. [3]

Q2. [Dec2019 – Q3] a) What are GnRH agonists and antagonists? [6] b) Discuss the clinical uses of GnRH agonists. [4]

Q3. [Dec2019 – Q8] a) Theories on pathogenesis of endometriosis. [3] b) Genetic basis of endometriosis. [7]

Q4. [Dec2018 – Q6] a) Dinogest. [5] b) GnRH antagonists. [5]

Q5. [June2018 – Q3] What is the role of minimally invasive surgery in a case of endometriosis? [5] Discuss the management of recurrent endometriosis in infertile women. [5]

Chapter 5: Minimally Invasive Surgery & Endoscopy

(8 Questions)

Q1. [Dec2022 – Q8] Natural Orifice Transluminal Endoscopic Surgery (NOTES) in Obstetrics and Gynaecology. [10]

Q2. [Dec2021 – Q6] a) Describe the classification of hysterectomy. [3] b) What are the complications of Laparoscopic hysterectomy? [3] c) What is the role of robot-assisted laparoscopy in gynaecology? [4]

Q3. [Dec2021 – Q8] a) Discuss indications, technique, and advantages of thermal ablation. [5] b) Describe the components and goals of the WHO call for action on patient safety. [5]

Q4. [Aug2021 – Q1] a) What is minimally invasive surgery? [2] b) Discuss the role of Minimally Invasive Surgery (MIS) in the management of women with gynaecological cancers. [8]

Q5. [Aug2021 – Q9] a) What is sentinel node? [2] b) Discuss the role of Sentinel lymph node biopsy in the management of Gynaecological cancers. [8]

Q6. [Dec2018 – Q2] a) Ergonomics in endoscopic surgery. [5] b) Principles of use of electrosurgical unit in gynaecological surgery. [5]

Q7. [Dec2018 – Q3] a) Third generation endometrial ablation techniques. [5] b) Radical trachelectomy for cervical cancer. [5]

Q8. [Dec2018 – Q10] a) Vaginal Intraepithelial Neoplasia. [5] b) Sentinel node. [5]

Chapter 6: Gynaecological Oncology

(4 Questions)

Q1. [June2022 – Q2] a) Describe the histological classification of vaginal intra-epithelial neoplasia (VaIN). [4] b) Discuss management options for VaIN. [6]

Q2. [Aug2021 – Q8] a) What are the current guidelines for cervical cancer screening? [5] b) Outline the management of precancerous lesions of cervix. [5]

Q3. [June2020 – Q2] Molecular biology of ovarian cancer and its clinical implications. [10]

Q4. [Dec2018 – Q8] a) Ovarian tumour markers. [5] b) Role of ovarian tumour markers in the management of ovarian cancer. [5]

Chapter 7: Stem Cells, Epigenetics & Reproductive Genetics

(3 Questions)

Q1. [Dec2021 – Q7] a) Define epigenetics. Discuss the role of epigenetics in disease and its therapeutic uses. [2+3] b) Discuss the ethical issues in use of stem cells. [5]

Q2. [June2020 – Q9] a) What are stem cells? [2] b) Role of stem cells in obstetrics and gynaecology. [8]

Q3. [June2019 – Q9] a) What are stem cells? [3] b) Role of stem cell therapy in gynaecology. [7]

Chapter 8: Uterine Anomalies, Fibroid & Endometrium

(4 Questions)

Q1. [Dec2019 – Q6] a) New classification of congenital uterine anomalies. [4] b) Management of hysteroscopic septal resection and its complications. [6]

Q2. [Dec2020 – Q9] a) What are the ethical issues involved with uterine transplantation? [3] b) Patient selection, evaluation and screening for uterine transplantation. [7]

Q3. [June2019 – Q4] a) Endometrium in menstrual cycle. [3] b) What is uterine biophysical profile? [3] c) Role of ultrasound and colour Doppler for assessment of endometrium. [4]

Q4. [June2018 – Q1] a) List the various non-surgical methods of treatment of leiomyoma. [5] b) Discuss the advantages and disadvantages of each method. [5]

Chapter 9: Surrogacy, Ethics & Legal Issues

(6 Questions)

Q1. [Dec2022 – Q4] a) Describe briefly the components of publication ethics. [4] b) Enumerate the types of plagiarism. [3] c) Discuss methods to avoid plagiarism. [3]

Q2. [June2022 – Q5] a) Describe the components of 'The Surrogacy (Regulation) Act, 2021'. [6] b) What were the challenges of commercial surrogacy? [4]

Q3. [Dec2021 – Q1] a) Write about MTP Amendment Act, 2021. [5] b) Discuss COVID vaccination in pregnancy. [5]

Q4. [Aug2021 – Q10] a) What is gender dysphoria in teenagers? [2] b) Discuss the issues and management of Transgender adolescents. [8]

Q5. [Dec2020 – Q5] a) What is Surrogacy and what are its medical indications? [5] b) Ethical issues in the Surrogacy Bill. [5]

Q6. [Dec2019 – Q5] a) What is Surrogacy and what are the medical indications? [5] b) Ethical issues in the Surrogacy Bill. [5]

Chapter 10: Obstetric Doppler, Ultrasound & Imaging

(3 Questions)

Q1. [Dec2022 – Q3] a) Write a note on role of Umbilical Coiling Index and its significance. [3] b) Discuss types of cord insertion. [2] c) Discuss diagnosis and management of vasa previa. [5]

Q2. [Dec2020 – Q8] Role of Doppler ultrasound for fetal surveillance. [10]

Q3. [Dec2019 – Q10] MRI in obstetrics. [7]

Chapter 11: Maternal Near Miss & Obstetric Emergencies

(3 Questions)

Q1. [June2022 – Q10] a) Define maternal near miss and its various etiologies. [4] b) Discuss the workup plan for sudden maternal collapse in labour. [6]

Q2. [Dec2018 – Q5] a) Maternal near miss and severe acute maternal morbidity. [5] b) Criteria for identifying maternal near miss cases. [5]

Q3. [June2019 – Q6] a) Define massive blood loss. [2] b) How will you estimate blood loss? [2] c) Significance of golden hour management. [2] d) Steps of management of massive blood loss. [4]

Chapter 12: HIV & Infectious Diseases in Pregnancy

(5 Questions)

Q1. [Dec2022 – Q6] Discuss the 4 essential components of prevention of HIV infection in pregnant woman and the neonate. [10]

Q2. [Aug2021 – Q7] a) What is the symptomology of COVID-19 infection during pregnancy? [5] b) Discuss COVID-19 vaccination during pregnancy. [5]

Q3. [Dec2020 – Q7] a) What is the effect of COVID-19 pandemic on obstetric services in India? [5] b) How will you manage a case of COVID-19 patients in pregnancy? [5]

Q4. [June2019 – Q7] a) Effect of HIV infection on pregnancy. [2] b) Effect of pregnancy on HIV infection. [2] c) Measures to prevent parent-to-child transmission of HIV. [6]

Q5. [June2018 – Q7] A HBsAg positive patient admitted at 36 weeks: a) What precautions will you observe to avoid transmission to the baby? [4] b) Management of the neonate born to HBsAg positive mother. [6]

Chapter 13: Anaemia & Nutrition in Pregnancy

(2 Questions)

Q1. [Dec2022 – Q7] Discuss various Government schemes for improvement and prevention of anaemia in pregnant women and newborns in India. [10]

Q2. [Dec2018 – Q9] a) Anaemia Mukt Bharat Programme. [5] b) National Nutrition Mission. [5]

Chapter 14: Hypertensive Disorders & Prediction

(1 Question)

Q1. [Aug2021 – Q4] a) Classify hypertensive disorders of pregnancy. [2] b) Discuss procedures taken for prediction and prevention of pre-eclampsia. [8]

Chapter 15: Newborn Care & Paediatric Conditions

(3 Questions)

Q1. [Dec2022 – Q5] a) Describe 'Baby Friendly Hospital Initiatives'. [5] b) Discuss 'Kangaroo Mother Care'. [5]

Q2. [June2020 – Q8] a) Role of Pre-Implantation Diagnostic Technique. [5] b) Cystic Hygroma in fetus during anomaly scan. [5]

Q3. [June2018 – Q8] A fetus in primigravida at 19 weeks noticed to have liver calcification on ultrasound: a) Discuss the causes of fetal liver calcification. [4] b) Management and counselling of the case. [6]

Chapter 16: Contraception & Family Planning

(2 Questions)

Q1. [June2022 – Q4] a) Describe components of Family Planning Indemnity Scheme (FPIS). [5] b) Describe the usage, indications, advantages and disadvantages of copper IUD. [5]

Q2. [June2019 – Q1] a) What are long-acting reversible contraceptives (LARC)? [2] b) Methods, indications, contraindications, risks and side effects of LARC. [8]

Chapter 17: Community Health & National Programmes

(1 Question)

Q1. [June2022 – Q3] a) Describe the role of gynaecologist in promoting Rastriya Kishore Swasthya Karyakaram (RKSK). [4] b) Discuss the management and counselling of adolescent girls with menstrual problems. [6]

Chapter 18: Premature Ovarian Insufficiency & Menopause

(1 Question)

Q1. [Dec2022 – Q2] a) Describe criteria for diagnosis of POI. [2] b) Discuss evaluation and management of POI. [8]

Chapter 19: Obesity & Bariatric Surgery

(2 Questions)

Q1. [June2019 – Q8] a) Pathophysiology of obesity. [4] b) Effect of obesity on reproductive life of women. [6]

Q2. [June2018 – Q5] A morbidly obese 30-year-old patient approaches for prepregnancy counselling before bariatric surgery: a) What will you counsel this patient? [5] b) Management during pregnancy after bariatric surgery. [5]

Chapter 20: Ectopic Pregnancy

(1 Question)

Q1. [June2020 – Q4] Recent advances in management of tubal ectopic pregnancy. [10]

Chapter 21: Urological Gynaecology

(1 Question)

Q1. [June2018 – Q6] a) Pathophysiology of urinary incontinence. [5] b) Medical management of overactive bladder. [5]

Chapter 22: Wound Healing & Surgical Principles

(1 Question)

Q1. [Dec2021 – Q2] a) Discuss the phases of acute wound healing. [3] b) What are the types of wound healing? [3] c) Discuss the role of topical negative pressure therapy in wound healing. [4]

Chapter 23: Selective Progesterone Receptor Modulators & SERMs

(1 Question)

Q1. [June2020 – Q10] a) What are selective progesterone receptor modulators? [2] b) What is the clinical utility of SERMs for management of gynaecological conditions? [8]

Chapter 24: Atypical Genital Appearance / DSD

(1 Question)

Q1. [June2022 – Q1] a) Describe the etiologies of atypical genital appearance at birth. [4] b) Discuss the evaluation of a case of neonate with atypical genital appearance. [6]

Chapter 25: Labour Analgesia & Alternative Birth

(1 Question)

Q1. [June2022 – Q8] a) Describe role of epidural analgesia in labour. [4] b) Discuss the pros and cons of water birth. [4] c) Describe the role of morphine in labour analgesia. [2]

Summary Table

Chapter	Topic	Qs
1	Prenatal Diagnosis & Genetics	11
2	ART & Infertility	22
3	Fetal Therapy & Invasive Procedures	6
4	Endometriosis	5
5	Minimally Invasive Surgery & Endoscopy	8
6	Gynaecological Oncology	4
7	Stem Cells, Epigenetics & Genetics	3
8	Uterine Anomalies, Fibroid & Endometrium	4
9	Surrogacy, Ethics & Legal Issues	6
10	Obstetric Doppler, Ultrasound & Imaging	3
11	Maternal Near Miss & Obstetric Emergencies	3
12	HIV & Infectious Diseases	5
13	Anaemia & Nutrition	2
14	Hypertensive Disorders & Prediction	1
15	Newborn Care & Paediatric Conditions	3
16	Contraception & Family Planning	2
17	Community Health & National Programmes	1
18	Premature Ovarian Insufficiency & Menopause	1
19	Obesity & Bariatric Surgery	2
20	Ectopic Pregnancy	1
21	Urological Gynaecology	1
22	Wound Healing & Surgical Principles	1
23	Selective Progesterone Receptor Modulators	1
24	Atypical Genital Appearance / DSD	1
25	Labour Analgesia & Alternative Birth	1
	TOTAL	100

Most repeated topics in Paper 4:

ART/IVF/Cryopreservation (asked almost every exam)
NIPT/Cell-free DNA (4×)
Surrogacy & Ethics (3×)
Fetal Therapy/EXIT surgery (3×)
Stem cells (2×)
Preimplantation Genetic Testing (3×)
Ovarian reserve (3×)
OHSS (2×)
Maternal near miss (2×)
Sentinel lymph node (2×)

Create comparison table of similar topics across all 4 papers

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Here is the complete chapter-wise list of all 100 Paper 3 questions (Dec 2018 – Dec 2022):

PAPER 3 — CHAPTER-WISE QUESTIONS

Gynaecology | Dec 2018 – Dec 2022 | 100 Questions

Chapter 1: Abnormal Uterine Bleeding (AUB) & Menstrual Disorders

(11 Questions)

Q1. [Dec2022 – Q2] a) Describe blood supply of reproductive organs. [5] b) Role of uterine artery embolization in abnormal uterine bleeding. [5]

Q2. [Dec2022 – Q5] a) Enumerate causes of primary amenorrhea. [4] b) How will you manage androgen insensitivity syndrome at 17 years of age? [6]

Q3. [Dec2022 – Q7] a) Define dysmenorrhea, types and describe the aetiology of dysmenorrhea. [5] b) Discuss the management of vaginismus in different age groups. [5]

Q4. [Dec2022 – Q8] a) Classify ovulatory disorders. [4] b) Describe the management of anovulatory cycles in a 30-year-old woman. [6]

Q5. [Dec2021 – Q7] Mrs. W, nulligravida, presented with history of heavy menstrual bleeding and inability to conceive. Examination revealed a large myomatous uterus: a) Discuss the management options. [6] b) What are the indications for myomectomy vs. hysterectomy? [4]

Q6. [Dec2021 – Q10] a) A 38-year-old Para 3 presents with irregular vaginal bleeding. She gives history of molar pregnancy 8 months ago. How will you investigate this case? [5] b) How will you manage persistent gestational trophoblastic disease? [5]

Q7. [Aug2021 – Q10] a) PALM COEIN Classification of abnormal uterine bleeding. [2] b) How will you classify and manage a case of fibroid uterus? [8]

Q8. [Dec2020 – Q8] a) Antra. [5] b) Missed pills. [5]

Q9. [Dec2019 – Q3] a) Describe the PALM COEIN classification of abnormal uterine bleeding. [5] b) Describe the non-surgical methods of managing the uterine fibroid. [5]

Q10. [Dec2018 – Q3] A 30-year P1L1 has abnormal uterine bleeding. The histopathology report of endometrial sample reveals hyperplasia with atypia: a) Discuss the management. [5] b) What are the prognostic factors of endometrial carcinoma? [5]

Q11. [June2018 – Q9] a) Discuss causes of heavy menstrual bleeding (HMB). [4] b) How will you evaluate a case of abnormal HMB in a 32-year multiparous woman? [3] c) Management of HMB due to adenomyosis. [3]

Chapter 2: Fibroids (Leiomyoma) & Uterine Artery Embolization

(1 Question)

Q1. [Aug2021 – Q3] Discuss indications, procedure and complications of Uterine Artery Embolization. [10]

Chapter 3: Endometrial Pathology

(7 Questions)

Q1. [June2022 – Q5] a) Detail the recent FIGO staging of endometrial cancer. [5] b) Describe the various prognostic factors and molecular markers in endometrial cancer. [5]

Q2. [June2020 – Q8] a) How is trophoblastic disease diagnosed? [5] b) What is the management strategy of trophoblastic disease? [5]

Q3. [June2020 – Q10] a) Management of recurrent vulvovaginal candidiasis. [5] b) Diagnosis and management of endometrial intraepithelial neoplasia. [5]

Q4. [Dec2019 – Q10] a) Endometrial hyperplasia and its associations. [6] b) Management of perimenopausal woman with simple cystic hyperplasia. [4]

Q5. [Dec2018 – Q7] A 60-year woman presents with postmenopausal bleeding: a) Discuss the differential diagnosis. [4] b) How will you investigate this case? [3] c) Management of endometrial carcinoma. [3]

Q6. [June2018 – Q5] a) What are the different types of endometrial hyperplasia? [2] b) Discuss briefly about the prognosis of each type. [3] c) How will you manage hyperplasia with atypia? [5]

Q7. [June2019 – Q6] a) FIGO staging of cervical cancer. [2] b) What are different modalities for staging cervical cancer? [2] c) What are the prognostic factors for cervical cancer? [6]

Chapter 4: Endometriosis

(2 Questions)

Q1. [Dec2021 – Q8] a) Discuss the etiology and clinical features of endometriosis. [4] b) What are the indications for surgery in case of endometriosis? [3] c) Describe the fertility workup in endometriosis. [3]

Q2. [Dec2018 – Q9] a) Medical management of endometriosis. [4] b) What is the role of laparoscopy in endometriosis? [3] c) Describe the fertility workup in endometriosis. [3]

Chapter 5: Polycystic Ovary Syndrome (PCOS) & Ovulation Induction

(8 Questions)

Q1. [June2022 – Q1] a) Describe clinical presentations of Ovarian Hyperstimulation Syndrome. [4] b) Discuss the risk factors and management of OHSS. [6]

Q2. [June2022 – Q7] a) Define hirsutism. How do you grade it? [3] b) Workup of a 20-year-old woman presenting with hirsutism. [3] c) Write the summary of management of hirsutism. [4]

Q3. [Aug2021 – Q8] a) Discuss the diagnostic criteria for PCOS. [2] b) Describe the management of an adolescent lady with PCOS. [8]

Q4. [Dec2020 – Q4] Outline the diagnostic evaluation of polycystic ovary syndrome in adolescents. [10]

Q5. [June2020 – Q1] a) What is induction of ovulation? [3] b) Enumerate the protocols of induction of ovulation. [3] c) Prevention and management of hyperstimulation. [4]

Q6. [Dec2019 – Q1] a) How will you induce ovulation in PCOS? [5] b) Prevention and management of ovarian hyperstimulation syndrome. [5]

Q7. [Dec2018 – Q1] A 25-year-old unmarried woman presents with excessive hair growth on the face: a) Enumerate the various causes of hirsutism. [3] b) Investigations for hirsutism. [3] c) Management of PCOS-related hirsutism. [4]

Q8. [Dec2018 – Q2] A 32-year-old woman with polycystic ovaries has successful IVF conception. Within a few days of embryo transfer she presents in the emergency with OHSS: a) Classify OHSS. [3] b) Management of severe OHSS. [7]

Chapter 6: Infertility

(3 Questions)

Q1. [Dec2022 – Q1] a) Enumerate causes of male factor infertility. [3] b) Describe evaluation and management of tubal infertility. [7]

Q2. [June2022 – Q3] a) Describe the etiologies of secondary infertility. [4] b) Discuss the management of a couple, both 32 years old, with 6 years of secondary infertility. [6]

Q3. [Aug2021 – Q2] a) Cause of infertility in genital tuberculosis. [5] b) Diagnosis of genital tuberculosis. [5]

Chapter 7: Gynaecological Infections & Vulvovaginal Conditions

(9 Questions)

Q1. [June2022 – Q10] a) List the etiologies of galactorrhoea in non-lactating women. [4] b) Discuss the workup and various management options for a 32-year-old woman with galactorrhoea and amenorrhoea. [6]

Q2. [Dec2021 – Q3] a) Mrs Q presents with features of acute PID. Discuss the complications and sequelae of PID. [3] b) Discuss the CDC guidelines for management of PID. [7]

Q3. [Dec2021 – Q4] a) Discuss role of Laser in Gynaecology. [5] b) How will you investigate a case of suspected genital tuberculosis? [5]

Q4. [Aug2021 – Q4] Write the causes and management of recurrent vulval ulcers. [10]

Q5. [Dec2019 – Q8] a) Normal vaginal microbial flora. [5] b) Treatment of recurrent vulvovaginal candidiasis. [5]

Q6. [June2019 – Q4] a) What is vulvodynia? [2] b) Classification of vulvodynia. [2] c) Management of localized vulvodynia. [6]

Q7. [June2019 – Q9] a) What are normal defense mechanisms of genital tract? [2] b) What are the causes of pruritus vulvae? [2] c) Diagnosis and management of lichen sclerosus. [6]

Q8. [Dec2018 – Q10] a) List the causes of pruritus vulvae. [3] b) How will you manage a woman presenting with white patch on labia minora? [4] c) What is lichen planus? [3]

Q9. [June2018 – Q4] a) What are the clinical manifestations of pelvic tuberculosis? [3] b) How will you diagnose pelvic tuberculosis? [4] c) Treatment of pelvic tuberculosis. [3]

Chapter 8: Pelvic Organ Prolapse & Urological Gynaecology

(13 Questions)

Q1. [June2022 – Q2] a) What is 'Genitourinary Syndrome of Menopause'? What are its symptoms? [4] b) How does it affect quality of life of a postmenopausal woman? [2] c) Management options. [4]

Q2. [June2022 – Q8] A 50-year-old parous woman presents with vault prolapse, post vaginal hysterectomy done 5 years back: a) Evaluate this patient. [4] b) Describe the surgical options for vault prolapse repair. [6]

Q3. [Dec2021 – Q5] a) Discuss the classification of pelvic organ prolapse. [6] b) Critically evaluate the treatment options available for a 26-year-old, para 1, with grade 3 uterovaginal prolapse. [4]

Q4. [Dec2021 – Q9] a) Define stress urinary incontinence (SUI). [2] b) Discuss the etiology and evaluation of SUI. [4] c) Critically appraise the vaginal tape procedures for SUI. [4]

Q5. [Dec2020 – Q3] a) Define stress urinary incontinence. Describe its etiology and evaluation in brief. [5] b) Management of a case of stress urinary incontinence. [5]

Q6. [Dec2020 – Q5] a) Pelvic organ prolapse quantification (POP-Q) classification of female genital prolapse. [5] b) Discuss in brief management of vault prolapse. [5]

Q7. [June2020 – Q2] a) How do you avoid ureteric injuries in endoscopic surgery? [5] b) Management of ureterovaginal fistula after hysterectomy. [5]

Q8. [June2020 – Q5] a) Define menopause. [2] b) Urethral syndrome. [4] c) Atrophic vaginitis. [4]

Q9. [Dec2019 – Q2] a) POP-Q classification of uterovaginal prolapse. [5] b) Management of vault prolapse. [5]

Q10. [Dec2019 – Q5] a) How will you avoid ureteric injuries at endoscopic surgery? [5] b) Management of ureterovaginal fistula after hysterectomy. [5]

Q11. [June2019 – Q3] a) Discuss disease spectrum and etiopathology of pelvic floor dysfunction. [4] b) Discuss pathophysiology, diagnosis and management of overactive bladder. [6]

Q12. [June2019 – Q7] a) What is extra-urethral incontinence? [2] b) What are causes of VVF (vesicovaginal fistula)? [2] c) Evaluation and management of VVF. [6]

Q13. [June2018 – Q6] a) What is vaginal vault prolapse? [2] b) Briefly describe the POP-Q staging of vault prolapse. [4] c) What techniques will you perform for repair? [4]

Chapter 9: Menopause & Postmenopausal Conditions

(3 Questions)

Q1. [Aug2021 – Q9] a) What are the causes of postmenopausal bleeding? [2] b) How will you manage a case of a 60-year-old lady with dirty foul-smelling discharge per vaginum? [8]

Q2. [Dec2020 – Q2] a) What are the clinical manifestations and diagnosis of menopause? [5] b) Causes of primary ovarian insufficiency. [5]

Q3. [June2019 – Q2] a) What is osteoporosis? [2] b) Write about prevention of postmenopausal osteoporosis. [2] c) Diagnosis and management of postmenopausal osteoporosis. [6]

Chapter 10: Chronic Pelvic Pain

(4 Questions)

Q1. [Dec2022 – Q4] A 26-year-old P1L1 with acute lower abdominal pain since 3 hours with history of irregular periods and chronic pelvic pain after LSCS 18 months back with history of treatment for Koch's: Discuss differential diagnosis and management. [10]

Q2. [Aug2021 – Q7] a) Define chronic pelvic pain. [2] b) Discuss the causes and management of chronic pelvic pain in women of reproductive age. [8]

Q3. [June2019 – Q5] a) What are ovarian remnant and residual ovary syndrome? [2] b) Give causes of chronic pelvic pain (CPP). [2] c) Management of a 28-year-old woman with CPP. [6]

Q4. [Dec2018 – Q8] a) Define chronic pelvic pain. [2] b) Discuss the causes of chronic pelvic pain. [4] c) Outline the management plan. [4]

Chapter 11: Cervical Pathology & Oncology

(7 Questions)

Q1. [Dec2022 – Q3] a) Describe methods of cervical carcinoma screening. [4] b) Describe the etiopathogenesis of CA cervix and describe methods of prevention of CA cervix. [6]

Q2. [June2022 – Q9] Colposcopic assessment of cervical intraepithelial neoplasia: a) Enlist the 4 main features that need to be observed for diagnosis. [4] b) Discuss the management of CIN 2 in a 25-year-old woman. [6]

Q3. [June2020 – Q4] a) Various modalities for screening of cancer cervix. [5] b) HPV vaccine. [5]

Q4. [Dec2019 – Q9] a) Liquid-based cytology in cervical screening. [3] b) Cervical screening guidelines. [7]

Q5. [June2019 – Q6] a) FIGO staging of cervical cancer. [2] b) What are different modalities for staging cervical cancer? [2] c) What are the prognostic factors for cervical cancer? [6]

Q6. [June2020 – Q3] (also covers ovarian) a) Enumerate FIGO classification of carcinoma ovary. [5] b) Differential diagnosis of ovarian tumours. [5]

Q7. [Dec2019 – Q7] (also covers ovarian) a) FIGO staging of Carcinoma ovary. [5] b) Management of a 16-year-old girl with a unilateral solid tumour in the ovary. [5]

Chapter 12: Ovarian Tumours & Oncology

(4 Questions)

Q1. [June2022 – Q6] a) What is meant by hormonally active ovarian tumour? Enlist various pathological types. [4] b) Diagnosis and management of an oestrogenising ovarian tumour. [6]

Q2. [Aug2021 – Q1] a) When will you suspect hereditary breast/ovarian cancer syndrome? [5] b) What are the strategies for prevention of hereditary ovarian cancer? [5]

Q3. [Dec2020 – Q1] a) Latest FIGO classification of ovarian cancer. [5] b) How will you manage a case of a 56-year-old woman with stage IIIc epithelial ovarian cancer? [5]

Q4. [June2019 – Q8] a) Give classification of benign ovarian neoplasms. [2] b) Diagnosis, complications and management of benign cystic teratoma. [8]

Chapter 13: Vulval Conditions & VIN

(1 Question)

Q1. [Dec2019 – Q4] a) Vulval intraepithelial neoplasia. [5] b) Management of lymph nodes in radical vulvectomy. [5]

Chapter 14: Contraception & Family Planning

(13 Questions)

Q1. [Dec2022 – Q9] A 19-year-old unmarried sexually active girl presented to adolescent clinic for contraceptive advice: a) Counsel her with appropriate contraceptive options. [5] b) Discuss emergency contraception. [5]

Q2. [June2022 – Q4] a) Discuss levonorgestrel intrauterine device — a boon in gynaecology. [5] b) Describe the management of a 28-year-old parous woman with heavy menstrual bleeding unsuitable for surgery. [5]

Q3. [Dec2021 – Q6] A young newly married couple wants to postpone childbirth for three years. Describe various methods which can be advised to them: a) Hormonal methods. [4] b) Barrier methods. [3] c) IUDs. [3]

Q4. [Aug2021 – Q5] Critically evaluate WHO Medical Eligibility Criteria for injection medroxyprogesterone acetate as a contraceptive. [10]

Q5. [Aug2021 – Q6] a) What are barrier contraceptives? [2] b) Discuss the benefits of using barrier contraceptives and their failure rates. [8]

Q6. [Dec2020 – Q6] a) WHO medical eligibility criteria for progesterone-only pills. [5] b) How will you manage a case of misplaced CuT? [5]

Q7. [Dec2020 – Q7] a) First trimester MTP. [5] b) Postpartum contraception. [5]

Q8. [Dec2020 – Q9] Enumerate the contraindications and complications of intrauterine contraceptive devices. [10]

Q9. [June2020 – Q6] a) Enumerate the non-hormonal contraceptive methods. [5] b) Contraindications, mechanism of action, complications of intrauterine contraceptive devices. [5]

Q10. [June2020 – Q7] a) Long-acting reversible contraceptives. [5] b) Emergency contraception. [5]

Q11. [Dec2019 – Q6] a) What are the non-contraceptive benefits of the oral contraceptive pill? [5] b) Discuss the contraindications and side effects of combined oral contraceptive pills. [5]

Q12. [June2019 – Q10] a) What are clinical uses of combined oral contraceptives (COCs)? [2] b) What are the adverse effects of COCs? [2] c) Contraindications of COCs. [3] d) Drug interactions with COCs. [3]

Q13. [Dec2018 – Q6] a) What are the contraceptives available today in the basket of choices under the National Family Planning Programme of India? [3] b) Non-contraceptive benefits of oral contraceptives. [4] c) WHO medical eligibility criteria for COC use. [3]

Chapter 15: Sterilization

(5 Questions)

Q1. [Dec2020 – Q10] Discuss the various techniques of female sterilization. [10]

Q2. [June2020 – Q9] a) What are the standards of female sterilization? [5] b) What are the different techniques of tubal ligation? [5]

Q3. [Dec2018 – Q4] Male sterilization is easier and safer than female sterilization: a) Justify this statement. [5] b) What is NSV (No-Scalpel Vasectomy)? [2] c) What are the complications of vasectomy? [3]

Q4. [June2018 – Q3] a) Describe in brief different modalities of tubal ligation. [5] b) What is the eligibility criteria for female sterilization with regard to parity and age? [5]

Q5. [Dec2021 – Q1] (also under Mullerian anomalies) a) Classify Mullerian duct anomalies. [4] b) What are the clinical problems associated with Mullerian duct anomalies? Outline the management. [6]

Chapter 16: MTP & Abortion

(2 Questions)

Q1. [June2019 – Q1] a) What is PCPNDT Act? [2] b) ART and PCPNDT Act. [2] c) Need of PGD (Preimplantation Genetic Diagnosis) clinics. [6]

Q2. [June2018 – Q8] a) Describe methods for second-trimester termination of pregnancy. [5] b) A case for MTP at 18 weeks received Mifepristone — discuss subsequent management. [5]

Chapter 17: Gynaecological Surgery & Anatomy

(2 Questions)

Q1. [Dec2018 – Q5] On the 5th post-operative day after abdominal hysterectomy, the patient develops urinary leak per vaginum: a) Institute a management protocol. [5] b) Discuss the steps of repair of VVF. [5]

Q2. [June2018 – Q2] a) Describe anatomy of anterior abdominal wall. [5] b) What are different types of incisions used in gynaecological surgeries? [5]

Chapter 18: Ectopic Pregnancy

(1 Question)

Q1. [June2018 – Q10] a) List the various modalities of treatment of ectopic pregnancy. [2] b) What is the criteria for patient selection for medical management of ectopic pregnancy? [4] c) Follow-up after medical management. [4]

Chapter 19: Tumour Markers in Gynaecology

(1 Question)

Q1. [Dec2021 – Q2] a) Enumerate various tumour markers used in gynaecology. [4] b) Discuss the clinical significance of various tumour markers. [6]

Chapter 20: Ovulation & Reproductive Endocrinology

(2 Questions)

Q1. [June2018 – Q1] a) Discuss the endocrinology of ovulation. [5] b) Briefly discuss various modalities to assess ovulation. [5]

Q2. [Dec2022 – Q10] (Prolapse with anaemia) A 34-year-old female with moderate anaemia presented with something coming out per vaginum since 8 months: a) How will you evaluate? [4] b) Discuss medical and surgical management. [6]

Chapter 21: Pyelonephritis in Pregnancy

(1 Question)

Q1. [Dec2022 – Q6] a) Discuss the etiopathogenesis of pyelonephritis in pregnancy. [2] b) Discuss its diagnosis, management and complications in pregnancy. [8]

Summary Table

#	Chapter	Questions
1	AUB & Menstrual Disorders	11
2	Fibroids & UAE	1
3	Endometrial Pathology	7
4	Endometriosis	2
5	PCOS & Ovulation Induction	8
6	Infertility	3
7	Gynaecological Infections & Vulvovaginal Conditions	9
8	Pelvic Organ Prolapse & Urological Gynaecology	13
9	Menopause & Postmenopausal Conditions	3
10	Chronic Pelvic Pain	4
11	Cervical Pathology & Oncology	7
12	Ovarian Tumours & Oncology	4
13	Vulval Conditions & VIN	1
14	Contraception & Family Planning	13
15	Sterilization	5
16	MTP & Abortion	2
17	Gynaecological Surgery & Anatomy	2
18	Ectopic Pregnancy	1
19	Tumour Markers	1
20	Ovulation & Reproductive Endocrinology	2
21	Pyelonephritis in Pregnancy	1
	TOTAL	100

Most repeated topics in Paper 3:

Contraception / IUDs / WHO MEC (13×) — highest frequency
Pelvic Organ Prolapse / POP-Q / Vault prolapse (8×) — asked every exam
PCOS / OHSS / Hirsutism / Ovulation induction (8×)
AUB / PALM COEIN (5×)
Cervical cancer screening / CIN / Colposcopy (5×)
Stress urinary incontinence (3×)
Chronic pelvic pain (4×)
Endometriosis (2×)
Ureteric injury / Ureterovaginal fistula (2×) — same question repeated Dec2019 & June2020
Sterilization techniques (4×)

Make chapter wise list of topic asked from the paper 2

Dont weite thw whole question make the chapter wise list of topic written in short

Running Command

Here is the concise chapter-wise topic list for Paper 2:

PAPER 2 — CHAPTER-WISE TOPIC LIST

(Dec 2018 – Dec 2022 | 100 Questions)

Chapter 1: Antepartum Fetal Surveillance & Fetal Wellbeing

Year	Topic
Dec2022	Antepartum fetal screening methods; Non-invasive prenatal diagnosis
Dec2022	Post-dates pregnancy management (41+2 weeks)
June2022	Decreased fetal movements — causes, investigations, management
Aug2021	Decreased fetal movements — causes & management
June2018	Intrapartum fetal surveillance modalities; Intrauterine resuscitation
June2018	IUFD — causes, management, counselling

Chapter 2: Prenatal Diagnosis & Gestational Age Assessment

Year	Topic
June2019	Assessment of gestational age; Indices of fetal maturity

Chapter 3: Preterm Labour, PPROM & Cervical Incompetence

Year	Topic
Dec2022	Incompetent cervix — etiopathology, diagnosis, cerclage types
June2022	Antenatal corticosteroids — advantages, disadvantages; Tocolytic drugs
Aug2021	Preterm neonate — causes of early neonatal death; management
Dec2020	Apgar score; Antenatal corticosteroids
June2020	PPROM — diagnosis; management at 30 weeks
June2018	Risk factors for prematurity; Complications; Interventions

Chapter 4: Hypertensive Disorders of Pregnancy

Year	Topic
Dec2022	WHO risk classification of heart disease in pregnancy; Mitral stenosis management
June2022	Antihypertensive drugs in pregnancy (dosage, side effects); Postpartum hypertension
Dec2020	Preeclampsia — definition; Eclampsia management at 34 weeks
Dec2019	Classification of hypertensive disorders; Role of antihypertensives in pre-eclampsia
Aug2021	Prediction & prevention of pre-eclampsia

Chapter 5: Antepartum Haemorrhage

Year	Topic
Dec2022	Nitabuch's layer; Placenta Accreta Spectrum (PAS) — diagnosis & management
Dec2021	Placenta previa — etiology, classification, management
June2020	Abruptio placentae — etiology & management
June2020	Placenta Accreta Syndrome (PAS) — definition, risk factors, diagnosis, management
June2019	Abruptio placentae — predisposing factors, Couvelaire uterus, management
Dec2019	Placenta accreta — imaging diagnosis; Management with previous CS
Dec2018	Anterior type 3 placenta praevia with previous LSCS — antenatal, delivery, intraoperative

Chapter 6: Medical Disorders in Pregnancy

Year	Topic
Dec2022	Physiological skin changes in pregnancy; Pruritus in pregnancy
Dec2022	Maternal collapse — causes & approach
Dec2022	Fever in pregnancy & puerperium; Malaria in pregnancy
June2022	Thrombocytopenia in pregnancy — classification & management of ITP
Dec2021	Hypothyroidism in pregnancy — preconception to postnatal management
Dec2021	Imaging safety in pregnancy; Goals of NRHM
Dec2021	HIV in pregnancy — management & PMTCT
Aug2021	Neonate of HIV positive mother; Early onset neonatal sepsis
Aug2021	Obstetric cholestasis — definition, diagnosis, management
Dec2020	Carbohydrate metabolism in pregnancy; Overt diabetes management
June2020	Epilepsy in pregnancy — course & drugs used
June2020	COVID-19 in pregnancy — antenatal care optimization & management
June2020	Acute fatty liver of pregnancy — etiopathology & management
Dec2019	Acute fatty liver of pregnancy; Differentiation from viral hepatitis
Dec2019	GDM screening methods; Neonatal complications of diabetic mother
June2019	SLE in pregnancy; APLA syndrome — diagnosis & management
June2019	Jaundice in pregnancy; Viral hepatitis in pregnancy
Dec2018	HIV prevention — vertical transmission; Labour management in HIV
Dec2018	Peripartum cardiomyopathy — differential diagnosis & management
Dec2018	Type 2 diabetes in pregnancy — preconception, antenatal, intrapartum
Dec2018	Obesity in pregnancy (BMI 38) — risks, antenatal, intrapartum management
June2018	Cardiovascular changes in pregnancy; Clinical indicators of heart disease; Mitral stenosis

Chapter 7: Rh Isoimmunization

Year	Topic
June2022	Rh isoimmunized pregnancy — definition & management with hydrops at 26 weeks

Chapter 8: Twin & Multiple Pregnancy

Year	Topic
Dec2022	Fetal hydrops — causes; Immune hydrops at 22 weeks
June2022	TTTS — genesis, diagnosis, management
Aug2021	Non-immune hydrops foetalis (NIHF) — management at 26 weeks
Aug2021	Twin gestation genesis; Monochorionic twin complications
June2020	TTTS — Quintero staging; Latest management
June2020	Chorionicity — assessment methods; Implications on outcome
Dec2019	Chorionicity — assessment methods; Implications
Dec2018	Antenatal tests for Down syndrome; MCDA twin management
Dec2018	Twin pregnancy complications; Management after delivery of first twin; Locked twins
June2018	Non-immune hydrops — etiopathogenesis & management
June2018	Triplet pregnancy — counselling, fetal reduction, antenatal management

Chapter 9: Fetal Growth Restriction & SGA

Year	Topic
June2022	SGA — definition, etiologies, workup, management at 32 weeks
June2018	FGR — definition, causes, diagnosis, management at 34 weeks

Chapter 10: Normal & Abnormal Labour

Year	Topic
Dec2021	WHO Labour Care Guide; CTG/Cardiotocography
Dec2021	Complications of induction of labour; Strategies to reduce LSCS rate
Dec2021	VBAC — prerequisites, intrapartum monitoring, scar dehiscence
Dec2020	Shoulder dystocia; Induction of labour
Dec2020	After-coming head in breech; Neglected shoulder presentation
June2019	Shoulder dystocia — diagnosis, complications, management
June2019	Trial labour — definition, contraindications, favourable/unfavourable factors
June2019	Rupture of uterus — diagnosis & management
June2022	Deep transverse arrest (DTA) — etiologies, management, complications
June2018	Augmentation vs induction; Prerequisites; Methods of induction
June2018	Pregnancy dating; Management of post-dates pregnancy
June2022	Caesarean scar pregnancy — diagnosis, risk factors, management
Dec2020	Medical management of ectopic pregnancy; Caesarean scar pregnancy
Dec2021	Medical methods of abortion — indications, contraindications, limitations

Chapter 11: Caesarean Section

Year	Topic
Dec2021	Strategies to reduce CS rate; Parenteral iron therapy; Partograph
Aug2021	Strategies to reduce CS rates; Indicators of maternal & neonatal health
Dec2018	Robson classification; Causes of rising CS rates; Methods to reduce

Chapter 12: Postpartum Haemorrhage & Third Stage

Year	Topic
Aug2021	Uterine inversion — classification & management
Dec2020	Acute uterine inversion; PPH management
Dec2019	Active management of third stage; Surgical management of atonic PPH
June2018	Cervical tear — causes, diagnosis, management

Chapter 13: Puerperal Complications & Sepsis

Year	Topic
June2022	Puerperal sepsis — organisms, management principles
Dec2020	Puerperal pyrexia — definition, causes; Puerperal sepsis management
June2019	Puerperal sepsis — definition, predisposing factors, management

Chapter 14: Neonatology

Year	Topic
Dec2020	Kangaroo mother care; Neonatal resuscitation
Dec2020	Neonatal sepsis — classification & management
June2020	Caput succedaneum vs subgaleal haematoma vs cephalhematoma
June2020	Essential newborn care; Neonatal jaundice; HIE
June2019	Congenital malformations as surgical emergencies; TOF
Dec2019	Respiratory distress syndrome; Differential diagnosis; Management
Dec2018	Neonatal jaundice — causes; Phototherapy rationale
Aug2021	Neonate of HIV positive mother; Early onset neonatal sepsis

Chapter 15: Gestational Trophoblastic Disease (GTD)

Year	Topic
Dec2022	GTD classification & pathogenesis; Persistent trophoblastic disease management

Chapter 16: Ectopic Pregnancy

Year	Topic
Dec2018	Types of ectopic; Emergency assessment; Medical management

Chapter 17: Abortion & Recurrent Pregnancy Loss

Year	Topic
Dec2019	Recurrent pregnancy loss — causes; Role of LMWH
June2019	MTP Act; Management of septic abortion

Chapter 18: External Cephalic Version (ECV)

Year	Topic
Aug2021	ECV — definition, prerequisites, complications

Chapter 19: Contraception & Family Planning

Year	Topic
Dec2021	Transdermal contraceptive patch; Postpartum contraception; Ulipristal acetate

Chapter 20: Preconception Counselling

Year	Topic
Aug2021	Preconception counselling in PCOS

Chapter 21: Community Obstetrics & Public Health

Year	Topic
Dec2019	ASHA worker — role & responsibilities

Summary

#	Chapter	No. of Topics
1	Antepartum Fetal Surveillance	6
2	Prenatal Diagnosis / Gestational Age	1
3	Preterm Labour, PPROM, Cerclage	6
4	Hypertensive Disorders	5
5	Antepartum Haemorrhage	7
6	Medical Disorders in Pregnancy	23
7	Rh Isoimmunization	1
8	Twin & Multiple Pregnancy	11
9	FGR & SGA	2
10	Normal & Abnormal Labour	14
11	Caesarean Section	3
12	PPH & Third Stage	4
13	Puerperal Complications	3
14	Neonatology	8
15	GTD	1
16	Ectopic Pregnancy	1
17	Abortion & RPL	2
18	ECV	1
19	Contraception	1
20	Preconception Counselling	1
21	Community Obstetrics	1
	TOTAL	100

Top high-yield chapters:

Medical Disorders in Pregnancy — 23 topics (diabetes, heart disease, HIV, hepatitis, epilepsy, thyroid, cholestasis, AFLP, COVID)
Twin & Multiple Pregnancy — 11 topics (TTTS, chorionicity, hydrops asked repeatedly)
Normal & Abnormal Labour — 14 topics
Antepartum Haemorrhage — 7 topics (PAS asked 4 times)
Neonatology — 8 topics

Make the list of questions asked from paper 1

Running Command

All 100 Paper 1 questions extracted. Now classifying them chapter-wise into short topics.

Here is the concise chapter-wise topic list for Paper 1:

PAPER 1 — CHAPTER-WISE TOPIC LIST

(Dec 2018 – Dec 2022 | 100 Questions)

Chapter 1: Anatomy of Female Pelvis & Pelvic Floor

Year	Topic
Dec2022	Types of female pelvis; Occipito-posterior in anthropoid pelvis
Dec2021	Anatomy of pelvic floor; OASIS — risk factors & management
Dec2021	Nerve supply of pelvis; Pain in 1st & 2nd stage of labour; Epidural analgesia
Dec2020	Anatomical types of female pelvis; Obstetrical significance
Dec2019	Superficial perineal pouch; Pudendal nerve & pudendal block
June2019	Anatomy of perineum; Obstetric anal sphincter injury (OASI) — classification & management
Aug2021	Anal sphincter complex (with diagram); OASIS — classification, prevention, treatment
Dec2018	Anatomy of pelvic diaphragm; POP-Q classification
June2022	Anatomy of ureter in relation to female genital tract; Sites of ureteric injury

Chapter 2: Anatomy — Vasculature & Lymphatics

Year	Topic
Dec2022	Lymphatic drainage of vulva; Carcinoma vulva — staging & management
June2022	Lymphatic drainage of cervix; Sentinel lymph node sampling in cervical cancer
Dec2020	Lymphatic drainage of female genital tract; Role of lymphadenectomy in malignancies
Aug2021	Internal iliac artery — course & branches; Internal iliac artery ligation
Dec2019	Internal iliac artery — anatomy & clinical significance
June2020	Internal iliac artery — branches; Procedure & indications for ligation
June2018	Blood supply of female genital tract; UAE in obstetrics & gynaecology

Chapter 3: Anatomy — Ureter, Bladder & Urinary Tract

Year	Topic
June2022	Ureter anatomy in relation to genital tract; Sites of ureteric injury
June2020	Course of ureter; Sites of injury during pelvic surgery
Aug2021	Mechanism of bladder continence; Pharmacological management of overactive bladder
Dec2020	Changes in urinary tract in pregnancy; Asymptomatic bacteriuria; Acute renal failure in pregnancy
Dec2019	Physiology of female urinary continence; Urinary retention in 1st trimester
June2018	Surgical anatomy of urinary bladder; Prevention of bladder injury
Dec2018	Urodynamic study; Management of genuine stress incontinence

Chapter 4: Anatomy — Abdominal Wall & Surgical Incisions

Year	Topic
Dec2021	Anatomy of anterior abdominal wall; Advantages & disadvantages of abdominal incisions
June2020	Wound healing; Steps to minimize risk of caesarean scar dehiscence

Chapter 5: Embryology & Development

Year	Topic
Dec2022	Development of Mullerian duct; Unicornuate uterus (U4) — diagnosis & management
Dec2021	Anti-Mullerian hormone — clinical significance; Unicornuate uterus
Dec2019	Development of Mullerian duct; Importance of AMH
June2020	Embryological development of female reproductive tract; Bicornuate uterus
June2018	Development of Mullerian duct; Classification & diagnosis of Mullerian anomalies
Dec2018	Embryological development of vagina; Anatomical abnormalities causing primary amenorrhoea

Chapter 6: Placenta & Implantation

Year	Topic
Dec2022	Normal placentation; Impact of abnormal placentation
June2022	Placental circulation; Doppler velocimetry in assessment of placental circulation
June2020	Implantation of pregnancy; Placental abnormalities in abnormal placentation
June2019	Placental circulation; Placental circulatory disturbances
Dec2018	Development of placenta; Fetal circulation (with diagram)

Chapter 7: Amniotic Fluid

Year	Topic
Dec2022	Physiology of amniotic fluid volume regulation; Polyhydramnios — complications & management
Dec2020	Physiology of AF formation; Functions; Clinical implications of AF abnormalities

Chapter 8: Coagulation & Thromboembolism in Pregnancy

Year	Topic
Dec2022	Physiological changes in coagulation during pregnancy; Thromboprophylaxis — risk factors & methods
Aug2021	Hypercoagulable state in pregnancy; VTE risk factors; Thromboprophylaxis
Dec2020	Pregnancy as thrombogenic condition; Thromboprophylaxis postnatal
Dec2018	Pathogenesis of DIC; Management of DIC
June2018	Risk factors for VTE in Obs & Gynae; Prevention of VTE

Chapter 9: Renal Physiology in Pregnancy

Year	Topic
Aug2021	Renal physiology in pregnancy; Pathogenesis of AKI
Aug2021	Fetomaternal haemorrhage — causes, measurement, management (Kleihauer-Betke)

Chapter 10: Reproductive Endocrinology & Menstrual Cycle

Year	Topic
June2022	Ovarian reserve tests; Premature ovarian failure causes; POF management
Dec2021	Endocrinology of menstruation; Adolescent HMB with severe anaemia
Aug2021	Corpus luteum — function; Corpus luteum dysfunction
Dec2019	Physiology of ovulation; Development of corpus luteum
June2019	Maturation of Graafian follicle & ovulation; Corpus luteum significance & management
June2020	Hypothalamo-pituitary-ovarian axis; Hypogonadotrophic hypooestrogenic infertility
June2018	Physiological changes in vagina during menstrual cycle; Bacterial vaginosis
Dec2018	Endocrinology of climacteric & menopause; Hormone therapy in postmenopause

Chapter 11: Puberty — Normal & Abnormal

Year	Topic
Dec2022	Stages of pubertal development; Precocious puberty management
Aug2021	Precocious puberty — definition, causes, management
Dec2020	Physiology of puberty; Delayed puberty — causes & management
June2019	Primary amenorrhoea — definition, causes; Turner's syndrome
June2018	Hormonal & physical changes in puberty; Precocious puberty — causes & management

Chapter 12: Primary Amenorrhoea

Year	Topic
June2022	Primary amenorrhoea — definition, etiologies, workup
June2019	Primary amenorrhoea — definition, causes; Turner's syndrome
Dec2018	Vaginal developmental abnormalities causing primary amenorrhoea

Chapter 13: Hyperprolactinaemia

Year	Topic
Dec2019	Causes of hyperprolactinaemia; Management

Chapter 14: Menopause

Year	Topic
June2019	Menopause — definition, symptoms; Non-hormonal treatment
Dec2018	Endocrinology of climacteric & menopause; Role of HRT

Chapter 15: Preeclampsia & Hypertensive Disorders

Year	Topic
June2022	Pathophysiology of preeclampsia; Systemic complications
Dec2018	Pathogenesis of preeclampsia; Complications & prevention

Chapter 16: Lactation & Breast

Year	Topic
Dec2022	Physiology of lactation; Management of inability to initiate lactation
Dec2018	Physiology of milk let-down; Early initiation of breastfeeding; Promotion of breastfeeding
June2019	Breast changes in pregnancy; Common breast complications & management

Chapter 17: Spermatogenesis & Male Infertility

Year	Topic
Dec2022	Spermatogenesis; Oligoasthenozoospermia management
Dec2018	WHO criteria for normal semen analysis; Evaluation of azoospermia

Chapter 18: Drugs in Pregnancy & Teratology

Year	Topic
Dec2019	Teratogens in pregnancy; Viral teratogens
June2019	FDA fetal risk categories; Maternal & fetal side effects of antibiotics
June2018	Physiological changes in thyroid function in pregnancy; Hypothyroidism complications

Chapter 19: Obstetric Labour — Physiology & Complications

Year	Topic
Dec2021	Phases of labour; Role of placenta in initiation of labour; Partograph
June2022	Retained placenta — causes & management
June2022	Breech presentation — causes; Management of multigravida with breech at 36 weeks
Dec2021	Umbilical cord — development & structure; Cord prolapse — clinical features & management
Dec2021	Heart disease in pregnancy — haemodynamic changes; Intrapartum & postpartum management
Aug2021	Massive blood transfusion — indications, protocols, adverse reactions

Chapter 20: Haematological Changes in Pregnancy

Year	Topic
Dec2019	Haematological changes in pregnancy; Physiological anaemia correlation

Chapter 21: Infections & Immunology in Pregnancy

Year	Topic
June2019	Immune adaptation of pregnancy; Maternal immunization for different pathogens
June2018	Vertical transmission — definition, risk factors, prevention of HIV

Chapter 22: Skin & Miscellaneous Changes in Pregnancy

Year	Topic
June2018	Pathological skin changes in pregnancy; Causes of pruritus in pregnancy
June2020	Cholestasis of pregnancy — etiopathogenesis, complications; Jaundice in pregnancy

Chapter 23: Ovulation & Infertility

Year	Topic
Dec2020	Tests for diagnosis of ovulation; OHSS — diagnosis, management & prevention
June2022	Ovarian reserve tests; Premature ovarian failure

Chapter 24: Oncology — Cervix & Endometrium

Year	Topic
Aug2021	FIGO classification of endometrial carcinoma; Evaluation of premalignant & malignant conditions
Dec2018	Cervical intraepithelial neoplasia (CIN); Cervical cancer screening methodology
June2018	Liquid Based Cytology — advantages; Pathogenesis of HPV infection; HPV vaccine
June2018	Bacterial vaginosis — diagnosis & treatment

Chapter 25: Preconception Counselling

Year	Topic
Dec2020	Pre-conceptional counselling; Counselling for previous baby with chromosomal abnormality

Chapter 26: Postpartum Mental Health

Year	Topic
June2019	Postpartum blues; Postpartum depression — risk factors & treatment

Chapter 27: Forensic & Legal Issues in Gynaecology

Year	Topic
Dec2020	Forensic evidence in sexual assault; POCSO Act; Counselling of survivor

Chapter 28: Doppler in Obstetrics & Gynaecology

Year	Topic
June2020	Doppler principle; Use of Doppler in gynaecological cases

Chapter 29: Research Methodology & Biostatistics

Year	Topic
June2022	Case-control study; Levels of evidence in research
Dec2021	Cohort study; Sampling techniques; Review of literature
Dec2021	Structure of research proposal; Study design for COVID vaccination evaluation
Dec2020	Types of analytic studies; Principles of RCT; CONSORT checklist
Dec2019	Applied research; Methods of sampling
June2020	Types of research; Framing a research question
June2020	Types of research studies; Study plan for drug evaluation
June2020	Randomization; Random sampling techniques; Bias types
June2019	How to form a hypothesis; Factors for strong scientific research; Types of research

Summary Table

#	Chapter	No. of Topics
1	Anatomy — Pelvis & Pelvic Floor	9
2	Anatomy — Vasculature & Lymphatics	7
3	Anatomy — Ureter, Bladder & Urinary Tract	7
4	Anatomy — Abdominal Wall & Incisions	2
5	Embryology & Development (Mullerian)	6
6	Placenta & Implantation	5
7	Amniotic Fluid	2
8	Coagulation & VTE in Pregnancy	5
9	Renal Physiology & Fetomaternal Haemorrhage	2
10	Reproductive Endocrinology & Menstrual Cycle	8
11	Puberty — Normal & Abnormal	5
12	Primary Amenorrhoea	3
13	Hyperprolactinaemia	1
14	Menopause	2
15	Preeclampsia & Hypertensive Disorders	2
16	Lactation & Breast	3
17	Spermatogenesis & Male Infertility	2
18	Drugs in Pregnancy & Teratology	3
19	Labour Physiology & Complications	6
20	Haematological Changes in Pregnancy	1
21	Infections & Immunology	2
22	Skin Changes & Cholestasis	2
23	Ovulation & Infertility	2
24	Oncology — Cervix & Endometrium	4
25	Preconception Counselling	1
26	Postpartum Mental Health	1
27	Forensic & Legal Issues	1
28	Doppler in Obs & Gynae	1
29	Research Methodology & Biostatistics	9
	TOTAL	100

High-yield chapters in Paper 1:

Research Methodology — 9 topics (asked every single exam)
Anatomy — Pelvis, Pelvic Floor, Vasculature, Ureter — ~23 topics combined
Reproductive Endocrinology — 8 topics
Embryology / Mullerian duct — 6 topics (repeated 5 times!)
Puberty (normal & precocious) — 5 topics
Placenta & Implantation — 5 topics
Coagulation & VTE — 5 topics (asked almost every exam)
Internal iliac artery — asked 3 times
Ureter anatomy & injury — asked 3 times

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