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Fetal growth restriction — MCCQE Part 1 MCQ

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EasyPregnancyFetal growth restrictionMCCQE Part 1

A 32-week pregnant woman has fundal height 27 cm; ultrasound shows estimated fetal weight below the 3rd percentile and abnormal umbilical artery Doppler. Which of the following is the most appropriate next step?

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Correct answer: C — Refer to maternal-fetal medicine or obstetrics for surveillance and delivery planning

Refer to maternal-fetal medicine or obstetrics for surveillance and delivery planning is the single best answer because the age, timing, examination findings and investigations in the vignette fit Fetal growth restriction better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC fetal growth restriction guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC fetal growth restriction guidance