Q: How do I interpret the Edinburgh Postnatal Depression Scale?

EPDS score ≥10 suggests possible postpartum depression and warrants clinical assessment. A score ≥13 indicates likely major depressive disorder. Question 10 (self-harm thoughts) should always be reviewed individually. ACOG recommends screening with a validated tool like EPDS at least once during the perinatal period. A positive screen requires further clinical evaluation, not automatic diagnosis.

Q: What is the Apgar score and when is it assessed?

The Apgar score (Appearance, Pulse, Grimace, Activity, Respiration) is assessed at 1 and 5 minutes after birth, on a 0–10 scale. Scores 7–10 are reassuring. Scores 4–6 are intermediate and may require stimulation. Scores <4 indicate need for immediate resuscitation. If the 5-minute score is <7, assessment continues at 10, 15, and 20 minutes. The 5-minute score better predicts neonatal outcomes.

Q: How accurate is the estimated fetal weight (EFW)?

Ultrasound-based EFW has a margin of error of approximately ±15–20% at term. The Hadlock formula (using BPD, HC, AC, FL) is most widely used. EFW is used to screen for macrosomia (>4000–4500 g) and fetal growth restriction (AC <10th percentile). Isolated macrosomia is not an indication for cesarean unless EFW exceeds 5000 g (no diabetes) or 4500 g (with diabetes) per ACOG.

Question 1

How is the estimated due date calculated?

Accepted Answer

Naegele's rule adds 280 days (40 weeks) to the first day of the last menstrual period (LMP). This assumes a 28-day cycle with ovulation on day 14. If LMP is unknown or cycles are irregular, first-trimester ultrasound CRL measurement is the most accurate dating method. ACOG recommends using ultrasound dating over LMP if the discrepancy is >7 days in the first trimester.

Question 2

What Bishop score indicates a favorable cervix for induction?

Accepted Answer

A Bishop score ≥8 indicates a favorable cervix and predicts successful vaginal delivery with oxytocin induction. Scores <6 are generally considered unfavorable and may warrant cervical ripening with misoprostol or Foley catheter before oxytocin. Scores 6–7 are intermediate. The Bishop score assesses cervical dilation, effacement, station, consistency, and position.

Question 3

How do I interpret the Edinburgh Postnatal Depression Scale?

Accepted Answer

EPDS score ≥10 suggests possible postpartum depression and warrants clinical assessment. A score ≥13 indicates likely major depressive disorder. Question 10 (self-harm thoughts) should always be reviewed individually. ACOG recommends screening with a validated tool like EPDS at least once during the perinatal period. A positive screen requires further clinical evaluation, not automatic diagnosis.

Question 4

What is the Apgar score and when is it assessed?

Accepted Answer

The Apgar score (Appearance, Pulse, Grimace, Activity, Respiration) is assessed at 1 and 5 minutes after birth, on a 0–10 scale. Scores 7–10 are reassuring. Scores 4–6 are intermediate and may require stimulation. Scores <4 indicate need for immediate resuscitation. If the 5-minute score is <7, assessment continues at 10, 15, and 20 minutes. The 5-minute score better predicts neonatal outcomes.

Question 5

How accurate is the estimated fetal weight (EFW)?

Accepted Answer

Ultrasound-based EFW has a margin of error of approximately ±15–20% at term. The Hadlock formula (using BPD, HC, AC, FL) is most widely used. EFW is used to screen for macrosomia (>4000–4500 g) and fetal growth restriction (AC <10th percentile). Isolated macrosomia is not an indication for cesarean unless EFW exceeds 5000 g (no diabetes) or 4500 g (with diabetes) per ACOG.

Medical Calculators for Obstetrics and Gynecology

Curated Tools for Obstetrics & Gynecology (10)

Due Date Calculator

Gestational Age Calculator

Bishop Score

Apgar Score

EPDS

Fetal Weight Calculator

BMI Calculator

Conception Calculator

Ovulation Calculator

BSA Calculator

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