Obstetric Anesthesia Practice Questions for AA Boards

Which blood pressure threshold constitutes severe-range hypertension in pregnancy?

1. Systolic ≥150 mmHg or diastolic ≥100 mmHg
2. Systolic ≥160 mmHg or diastolic ≥110 mmHg
3. Systolic ≥180 mmHg and diastolic ≥120 mmHg only
4. Systolic ≥140 mmHg and diastolic ≥90 mmHg only

Correct answer: B

Either a systolic pressure of at least 160 mmHg or a diastolic pressure of at least 110 mmHg meets the severe-range threshold. Both do not need to be elevated. The reading requires prompt assessment and appropriate confirmation and management. Preeclampsia with severe features can also involve organ dysfunction; blood pressure alone is not a complete definition of that diagnosis.

Source: https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy

In an otherwise uncomplicated pregnancy, spinal-anesthesia-associated hypotension during cesarean delivery requires a vasopressor. Maternal heart rate is 85/min. Which finding supports choosing phenylephrine over ephedrine in this setting?

1. Phenylephrine has no potential to cause bradycardia
2. Phenylephrine is associated with more favorable fetal acid–base status
3. Phenylephrine guarantees greater uteroplacental blood flow in every patient
4. Ephedrine cannot treat hypotension during neuraxial anesthesia

Correct answer: B

Both phenylephrine and ephedrine can treat neuraxial hypotension. In the absence of maternal bradycardia, ASA guidance supports considering phenylephrine because of more favorable fetal acid–base status in uncomplicated pregnancies. This does not establish superior uteroplacental flow or better clinical neonatal outcomes in every situation. Phenylephrine can produce reflex bradycardia, so maternal heart rate and the clinical context matter.

Source: ASA/SOAP Practice Guidelines for Obstetric Anesthesia (2016), vasopressors for neuraxial hypotension: https://www.asahq.org/~/media/sites/asahq/files/public/resources/standards-guidelines/practice-guidelines-for-obstetric-anesthesia.pdf

Compared with the nonpregnant state, functional residual capacity in a healthy patient at term is typically decreased by approximately how much?

1. 20%
2. 5%
3. 50%
4. 75%

Correct answer: A

Functional residual capacity decreases by roughly 20% by term, with further reduction possible in the supine position. The reduced pulmonary oxygen reserve, together with increased oxygen consumption, contributes to more rapid desaturation during apnea. This is an approximate physiologic change, not an exact value for every patient or every gestational age.

Source: WFSA Anaesthesia Tutorial of the Week 25. Physiological Changes Associated with Pregnancy, Respiratory system: https://resources.wfsahq.org/wp-content/uploads/25_english-1.pdf

What obstetric anesthesia topics are included?

Included topics are maternal physiologic changes, uteroplacental perfusion, neuraxial analgesia, cesarean delivery, preeclampsia, hemorrhage, and emergency airway planning.

Are these obstetric questions real question-bank previews?

Yes. Each preview comes from the Anesthesia Review practice bank and includes its original choices, explanation, and reference.

How should I study obstetric anesthesia for boards?

Start with normal maternal physiology, then organize complications by how they change oxygenation, perfusion, coagulation, airway risk, and the choice between neuraxial and general anesthesia.