A pregnant woman presents for an antenatal check-up at 36 weeks of gestation. Which of the following investigations should be performed at this time?

1. A

   Glucose Tolerance Test

2. B

   Amniotic fluid assessment

3. C

   Fetal anomaly scan

4. D

   Culture of vaginal swab for infection

Appeared in: NORCET-11 Prelims

Explanation

• Amniotic fluid assessment is a standard investigation at 36 weeks to monitor fetal well-being.
• It helps detect oligohydramnios or polyhydramnios, which can affect fetal outcomes.
• Assessment is done by ultrasound, measuring AFI or deepest vertical pocket.
• Guides clinical decisions about timing and mode of delivery if abnormalities are found.

Why Other Options Were Wrong

• Option A: Glucose Tolerance Test (GTT) is typically performed between 24–28 weeks to screen for gestational diabetes, not at 36 weeks.
• Option C: Fetal anomaly scan (detailed ultrasound) is done in the second trimester, usually between 18–22 weeks, to detect structural abnormalities.
• Option D: Culture of vaginal swab for infection (e.g., Group B Streptococcus) is recommended between 35–37 weeks, but is not a universal investigation for all women in India unless risk factors are present.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Routine antenatal investigations at 36 weeks gestation as background academic context rather than a clinical decision trigger.
• Nurses must monitor amniotic fluid volume in late pregnancy to identify risks for fetal distress or complications during labor.
• Early detection of abnormal fluid levels can prompt timely intervention, improving neonatal outcomes.
• What if? If the woman was at 24 weeks, GTT would be the correct investigation; if she had symptoms of infection, a vaginal swab would be prioritized.

How to Approach the Question

• Identify the gestational age and match it to the standard schedule of antenatal investigations.
• Recall which tests are routine at each trimester (early, mid, late pregnancy).
• Eliminate options that are done earlier (GTT, anomaly scan).
• Consider clinical protocols for infection screening and fetal surveillance.
• Select the investigation that is universally indicated at 36 weeks for fetal well-being.

Concept Tested & Keywords

• Concept Tested: Routine antenatal investigations at 36 weeks gestation
• Stem keywords: pregnant woman, antenatal check-up, 36 weeks gestation
• Lead-in keywords: should be performed
• Clinical cues: late third trimester
• Clinical cues: routine fetal surveillance

Question ID

QrWntEwS1-NNw2CTrKg6GR

Copy ID

Reference Book

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 19-27