ObGyn Intel
ObGyn Intelligence
← All Tools
MFM Subspecialty · 100 Questions
📋 MFM Subspecialist Level Only

Maternal-Fetal Medicine
100 Questions

High-complexity questions spanning the full scope of MFM subspecialty practice — calibrated for experienced subspecialists and MFM fellows. Each question opens Claude or ChatGPT with instructions to respond at the highest evidence level with primary citations.

Amos Grünebaum, MD · Professor of Obstetrics & Gynecology, Maternal-Fetal Medicine
🔓 Subspecialist use only. These questions and AI responses are calibrated for experienced MFM practitioners. The AI is instructed to cite 3–5 primary peer-reviewed references per response from AJOG, NEJM, Lancet, SMFM, or major MFM trial publications. Always verify citations independently.
1
Fetal Growth Restriction: Pathophysiology and Management
10 questions
1
What is the evidence distinguishing placental versus constitutional FGR using Doppler, biometry, and biomarkers?
Claude GPT
2
What are the PORTO and TRUFFLE trial criteria for FGR surveillance and how do they inform delivery timing?
Claude GPT
3
What is the evidence for the cerebroplacental ratio as a predictor of adverse perinatal outcome in late-onset FGR?
Claude GPT
4
How does absent versus reversed end-diastolic flow in the umbilical artery change delivery decision-making by gestational age?
Claude GPT
5
What is the role of ductus venosus Doppler in the terminal stages of fetal compromise and what does the a-wave predict?
Claude GPT
6
What is the evidence for the ISUOG staging system for FGR and how does it compare to the Delphi consensus?
Claude GPT
7
What is the pathophysiology of brain-sparing and at what point does it fail to protect the fetal brain?
Claude GPT
8
What is the evidence on expectant management versus delivery for early-onset FGR between 26 and 32 weeks?
Claude GPT
9
What biomarkers — sFlt-1, PlGF, PAPP-A — have the strongest predictive value for early-onset FGR?
Claude GPT
10
What is the recurrence risk of FGR and what interventions have evidence for prevention in a subsequent pregnancy?
Claude GPT
2
Preeclampsia: Prediction, Prevention, and Critical Management
10 questions
11
What is the first-trimester combined screening algorithm for preeclampsia and what are its detection rates?
Claude GPT
12
What is the evidence for the sFlt-1:PlGF ratio in predicting preeclampsia onset within two weeks?
Claude GPT
13
What is the ASPRE trial and how did it redefine low-dose aspirin dosing and timing for preeclampsia prevention?
Claude GPT
14
What is the mechanism by which low-dose aspirin prevents early-onset preeclampsia?
Claude GPT
15
What is the CHIPS trial and how did it define tight versus less-tight blood pressure control in pregnancy?
Claude GPT
16
What is the evidence for magnesium sulfate versus phenytoin for seizure prophylaxis in severe preeclampsia?
Claude GPT
17
What is the MAGPIE trial and what neonatal considerations arise from maternal magnesium therapy?
Claude GPT
18
What antihypertensive achieves the fastest blood pressure control in acute severe hypertension and what is the evidence?
Claude GPT
19
What is atypical preeclampsia and how does it challenge the diagnostic criteria?
Claude GPT
20
What is the long-term cardiovascular risk stratification for women after preeclampsia and what follow-up is evidence-based?
Claude GPT
3
Preterm Birth: Pathobiology, Prediction, and Intervention
10 questions
21
What is the evidence for cervical length measurement combined with fetal fibronectin in predicting spontaneous preterm birth?
Claude GPT
22
What is the pathobiology of intrauterine infection-driven preterm birth and how does it inform antibiotic choice?
Claude GPT
23
What is the evidence for vaginal progesterone versus 17-OHPC for preterm birth prevention in singleton pregnancies?
Claude GPT
24
What did the PROLONG trial show about 17-OHPC and how does it conflict with the MFMU 2003 trial?
Claude GPT
25
What is the evidence for cervical cerclage in women with prior preterm birth and a short cervix versus history alone?
Claude GPT
26
What is the role of the arabin pessary in preterm birth prevention and what did the ProTWIN and PECEP trials show?
Claude GPT
27
What is the evidence for tocolysis beyond 48 hours and which agents have the best short-term safety profiles?
Claude GPT
28
What is the fetal inflammatory response syndrome and how does it affect neonatal outcomes independently of gestational age?
Claude GPT
29
What is the evidence for antenatal magnesium sulfate for fetal neuroprotection and what are the dosing protocols?
Claude GPT
30
What is the role of progestogen supplementation after a cervical cerclage in preventing recurrent preterm birth?
Claude GPT
4
Placenta: Accreta Spectrum, Previa, and Abruption
10 questions
31
What is the evidence-based ultrasound and MRI criteria for diagnosing placenta accreta spectrum?
Claude GPT
32
What is the sensitivity and specificity of color Doppler lacunae versus MRI for predicting surgical blood loss in PAS?
Claude GPT
33
What is the optimal surgical approach for planned cesarean hysterectomy in placenta percreta?
Claude GPT
34
What is the evidence for uterine artery embolization and balloon occlusion in reducing hemorrhage in PAS?
Claude GPT
35
What is the cell salvage evidence in PAS and when is it contraindicated?
Claude GPT
36
What is the clinical staging of placenta accreta spectrum according to FIGO and how does it guide multidisciplinary planning?
Claude GPT
37
What are the evidence-based criteria for expectant management of PAS and what are its maternal and perinatal risks?
Claude GPT
38
What is the pathophysiology of placental abruption and what biomarkers or clinical features predict severity?
Claude GPT
39
What is the evidence for delivery timing in chronic abruption with fetal growth restriction?
Claude GPT
40
What is a vasa previa type I versus type II and what are the evidence-based screening protocols for each?
Claude GPT
5
Multiple Gestations: TTTS, sIUGR, and TAPS
10 questions
41
What is the Quintero staging system for TTTS and what are the limitations of its prognostic value?
Claude GPT
42
What is the evidence for fetoscopic laser photocoagulation versus amnioreduction in stage II-IV TTTS?
Claude GPT
43
What is the Solomon technique for laser photocoagulation and what does it reduce compared to selective laser?
Claude GPT
44
What is selective fetal growth restriction in monochorionic twins and how is umbilical artery Doppler used for classification?
Claude GPT
45
What is twin anemia polycythemia sequence and how is it diagnosed postnatally and prenatally?
Claude GPT
46
What is the evidence for expectant management versus intervention in type II sIUGR in monochorionic twins?
Claude GPT
47
What is the recurrence risk of TTTS after laser treatment and what surveillance protocol is recommended?
Claude GPT
48
What is the evidence for selective feticide in discordant anomalies in monochorionic versus dichorionic twins?
Claude GPT
49
What is the timing of delivery recommendation for uncomplicated MCDA versus DCDA twin pregnancies by evidence?
Claude GPT
50
What is the evidence on neurological morbidity in the surviving co-twin after single fetal demise in monochorionic pregnancy?
Claude GPT
6
Fetal Anemia, Hydrops, and Transfusion
10 questions
51
What is the evidence-based threshold for middle cerebral artery PSV as a trigger for fetal blood sampling and transfusion?
Claude GPT
52
What is the hemolytic disease of the fetus and newborn pathophysiology for anti-Kell compared to anti-D?
Claude GPT
53
What is the evidence for intrauterine transfusion technique via intrahepatic vein versus intracardiac approach in hydrops?
Claude GPT
54
What is the optimal hematocrit target after intrauterine transfusion and how is the transfusion volume calculated?
Claude GPT
55
What is the evidence for IUT frequency intervals and what hemoglobin decline rate should guide re-transfusion timing?
Claude GPT
56
What is the pathophysiology of non-immune hydrops and what are the most common etiologies by gestational age?
Claude GPT
57
What is the evidence for maternal IVIG in anti-D and anti-Kell alloimmunization to delay or reduce transfusion frequency?
Claude GPT
58
What is mirror syndrome and what are the maternal manifestations in the setting of severe fetal hydrops?
Claude GPT
59
What is the evidence on neurodevelopmental outcomes in fetuses requiring multiple intrauterine transfusions?
Claude GPT
60
What is the current evidence on anti-D prophylaxis dosing in the first trimester versus standard third trimester regimens?
Claude GPT
7
Congenital Anomalies and Fetal Intervention
10 questions
61
What is the evidence for fetal myelomeningocele repair: the MOMS trial outcomes and long-term follow-up data?
Claude GPT
62
What are the current eligibility criteria for open fetal surgery for myelomeningocele repair and what are the maternal risks?
Claude GPT
63
What is fetoscopic MMC repair and what are the procedural advantages and outcomes compared to open surgery?
Claude GPT
64
What is the evidence for FETO in severe pulmonary hypoplasia due to congenital diaphragmatic hernia?
Claude GPT
65
What is the lung-to-head ratio and observed-to-expected LHR and how do they predict CDH outcomes?
Claude GPT
66
What is the evidence for thoracoamniotic shunting in large fetal hydrothorax and its effect on hydrops resolution?
Claude GPT
67
What is the evidence for vesicoamniotic shunting in lower urinary tract obstruction and which fetuses benefit?
Claude GPT
68
What is radiofrequency ablation versus bipolar cord coagulation for selective feticide in monochorionic twins with anomalies?
Claude GPT
69
What is fetal cardiac intervention — balloon valvuloplasty for aortic stenosis — and what are the selection criteria and outcomes?
Claude GPT
70
What is the evidence for ex utero intrapartum treatment for large fetal neck masses and airway obstruction?
Claude GPT
8
Maternal Cardiac and Pulmonary Disease in Pregnancy
10 questions
71
What is the modified WHO classification for maternal cardiac risk and which conditions are class IV?
Claude GPT
72
What is Eisenmenger syndrome and what is the maternal mortality risk in pregnancy?
Claude GPT
73
What is the evidence for beta-blocker use in Marfan syndrome during pregnancy and what aortic diameter triggers delivery planning?
Claude GPT
74
What is the peripartum cardiomyopathy diagnostic criteria and evidence for bromocriptine therapy?
Claude GPT
75
What is the evidence for anticoagulation in mechanical heart valve replacement during pregnancy?
Claude GPT
76
What is the evidence for heparin versus warfarin in the first trimester for mechanical valve thromboembolism prevention?
Claude GPT
77
What is the management of acute pulmonary embolism in pregnancy and what is the evidence for thrombolysis?
Claude GPT
78
What is pulmonary arterial hypertension in pregnancy and what targeted therapies have evidence for use?
Claude GPT
79
What is the evidence for planned delivery timing and mode in women with significant structural heart disease?
Claude GPT
80
What is the CARPREG II risk score and how does it predict adverse cardiac events in pregnant women with heart disease?
Claude GPT
9
Thrombophilia, Antiphospholipid Syndrome, and Maternal Autoimmune Disease
10 questions
81
What is the revised Sapporo criteria for antiphospholipid syndrome and what defines triple positivity?
Claude GPT
82
What is the evidence for heparin plus aspirin versus aspirin alone in obstetric APS with recurrent pregnancy loss?
Claude GPT
83
What is the evidence for hydroxychloroquine in pregnant women with SLE and its effect on disease flares?
Claude GPT
84
What is neonatal lupus and what anti-Ro/SSA titer predicts congenital heart block?
Claude GPT
85
What is the evidence for serial fetal PR interval monitoring to detect early congenital heart block in anti-Ro positive women?
Claude GPT
86
What is the evidence for IVIG and dexamethasone in preventing progression of first-degree to complete congenital heart block?
Claude GPT
87
What is catastrophic antiphospholipid syndrome and what are its treatment options in pregnancy?
Claude GPT
88
What is the evidence for inherited thrombophilia screening after recurrent pregnancy loss and which mutations are clinically actionable?
Claude GPT
89
What is the evidence for thromboprophylaxis in pregnant women with heterozygous Factor V Leiden without prior VTE?
Claude GPT
90
What is the optimal low-molecular-weight heparin regimen in pregnancy and how is anti-Xa monitoring used?
Claude GPT
10
Fetal Neurology, Genetics, and Advanced Prenatal Diagnosis
10 questions
91
What is the evidence for chromosomal microarray versus standard karyotype in fetuses with ultrasound anomalies?
Claude GPT
92
What is exome sequencing in prenatal diagnosis and what is the incremental yield over chromosomal microarray in anomalous fetuses?
Claude GPT
93
What is the evidence and limitations of whole genome sequencing for prenatal diagnosis of fetal anomalies?
Claude GPT
94
What is the classification of fetal ventriculomegaly and what additional workup is indicated at each severity threshold?
Claude GPT
95
What is the evidence for fetal MRI in evaluating posterior fossa abnormalities diagnosed on ultrasound?
Claude GPT
96
What is iso-intense signal on fetal brain MRI and what does it indicate about cortical maturation?
Claude GPT
97
What is the pathophysiology and prognosis of fetal agenesis of the corpus callosum with and without associated anomalies?
Claude GPT
98
What is the SMFM classification of fetal anomalies for counseling — isolated versus syndromic versus lethal — and how is it applied?
Claude GPT
99
What is expanded carrier screening yield and how does residual risk change counseling after a positive carrier result?
Claude GPT
100
What is the evidence for RNA sequencing and proteomics as emerging tools in prenatal diagnosis of fetal anomalies?
Claude GPT