Labour complications: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Labour complications

Sample item

After delivery of the fetal head in a diabetic mother, the head retracts against the perineum (turtle sign) and the anterior shoulder fails to deliver with routine traction. What is the first manoeuvre?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. McRoberts position with suprapubic pressure

Shoulder dystocia is impaction of the anterior shoulder behind the pubic symphysis. McRoberts manoeuvre (hyperflexion of the thighs onto the abdomen) straightens the sacrum and rotates the pelvis, with suprapubic pressure to dislodge the shoulder. Fundal pressure is avoided because it worsens impaction.

Option by option

  • A. Fundal pressure

    Fundal pressure drives the shoulder further against the symphysis and is contraindicated.

  • B. McRoberts position with suprapubic pressure (correct)

    Correct. McRoberts with suprapubic pressure resolves most cases.

  • C. Forceps rotation

    Forceps cannot free an impacted shoulder and risk fetal injury.

  • D. Attempt Zavanelli manoeuvre (cephalic replacement) as the first step

    Cephalic replacement is a last-resort rescue after other manoeuvres have failed, not the first step.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, McRoberts position with suprapubic pressure. Shoulder dystocia is impaction of the anterior shoulder behind the pubic symphysis.

Why is "Fundal pressure" not the answer?

Fundal pressure drives the shoulder further against the symphysis and is contraindicated.

Why is "Forceps rotation" not the answer?

Forceps cannot free an impacted shoulder and risk fetal injury.

Why is "Attempt Zavanelli manoeuvre (cephalic replacement) as the first step" not the answer?

Cephalic replacement is a last-resort rescue after other manoeuvres have failed, not the first step.

What concept does this question test?

It tests Labour complications in OBG. McRoberts manoeuvre (hyperflexion of the thighs onto the abdomen) straightens the sacrum and rotates the pelvis, with suprapubic pressure to dislodge the shoulder. Fundal pressure is avoided because it worsens impaction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Labour complications?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.