Normal & Abnormal Labour

Topics in this chapter

• Normal Labour and Stages
• Labour Monitoring and Partograph
• Fetal Position and Cardinal Movements
• Malpresentation and Dystocia
• Operative Delivery and Vacuum
• Third Stage and Postpartum Haemorrhage
• Shoulder Dystocia
• Uterine Rupture

Practice questions

1. Question 1Q-334C1C

   A 28-year-old primigravida at 39 weeks of gestation presents in active labor. On digital vaginal examination, the cervix is fully dilated and fully effaced. The leading part is the vertex at station +2, with the sagittal suture in the right oblique diameter and the small fontanel located towards the left anterior quadrant of the maternal pelvis. What is the exact fetal position?

   1. A.Left occipito-anterior (LOA)
   2. B.Right occipito-anterior (ROA)
   3. C.Left occipito-posterior (LOP)
   4. D.Right occipito-posterior (ROP)
   See the answer and solution
2. Question 2Q-B7122A

   A 25-year-old primigravida is in the active phase of the first stage of labor. According to Friedman's and modern labor curves, what is the minimum expected rate of cervical dilation in a nulliparous woman during the active phase?

   1. A.0.5 cm/hour
   2. B.1.2 cm/hour
   3. C.2.0 cm/hour
   4. D.2.5 cm/hour
   See the answer and solution
3. Question 3Q-903F9D

   A multiparous woman at term is admitted in active labor. Cervical dilation progresses normally to 6 cm, after which there is no change in cervical dilation or station for 4 hours despite adequate uterine contractions (greater than 200 Montevideo units). What is the most appropriate diagnosis?

   1. A.Prolonged latent phase
   2. B.Secondary arrest of dilation
   3. C.Arrest of descent
   4. D.Protracted active phase dilation
   See the answer and solution
4. Question 4Q-6F6500

   Which of the following cardinal movements of labor occurs concurrently with engagement and descent, primarily serving to protect the narrowest pelvic diameter by presenting the smallest cephalic circumference?

   1. A.Internal rotation
   2. B.Extension
   3. C.Flexion
   4. D.Restitution
   See the answer and solution
5. Question 5Q-3025BE

   A 30-year-old G2P1L1 presents at 40 weeks with spontaneous rupture of membranes and strong regular contractions. Pelvic assessment reveals a brow presentation persisting at the pelvic brim with no descent. Which of the following is the standard management for a persistent brow presentation at term with an average-sized fetus?

   1. A.Trial of labor with oxytocin augmentation
   2. B.Manual conversion to vertex presentation
   3. C.Lower segment cesarean section
   4. D.Vacuum-assisted vaginal delivery
   See the answer and solution