Labour and delivery: Kustner sign: 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 and delivery: Kustner sign

Sample item

In the third stage, the attendant presses with the hand above the symphysis pubis and notices that the umbilical cord at the vulva is drawn back into the vagina. How should this be interpreted?

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

The answer and the reasoning

C. The placenta has not yet separated

In Kustner's test, suprapubic pressure pushes the uterus upward. If the cord retracts, it is still attached to the adherent placenta; if the cord stays still or advances, the placenta has separated. Other signs of separation are cord lengthening, a gush of blood, and a firm globular fundus.

Option by option

  • A. The uterus has inverted

    Uterine inversion presents with a mass in the vagina, severe pain and shock.

  • B. The cord has been avulsed

    Cord avulsion would leave no cord to be drawn back.

  • C. The placenta has not yet separated (correct)

    Correct. A cord that ascends under suprapubic pressure is still anchored to an unseparated placenta.

  • D. The placenta has separated and descended

    If the placenta had separated, the cord would stay put or descend.

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 C, The placenta has not yet separated. In Kustner's test, suprapubic pressure pushes the uterus upward.

Why is "The uterus has inverted" not the answer?

Uterine inversion presents with a mass in the vagina, severe pain and shock.

Why is "The cord has been avulsed" not the answer?

Cord avulsion would leave no cord to be drawn back.

Why is "The placenta has separated and descended" not the answer?

If the placenta had separated, the cord would stay put or descend.

What concept does this question test?

It tests Labour and delivery: Kustner sign in OBG. If the cord retracts, it is still attached to the adherent placenta; if the cord stays still or advances, the placenta has separated. Other signs of separation are cord lengthening, a gush of blood, and a firm globular fundus.

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 and delivery: Kustner sign?

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.