Labour and delivery: Zavanelli manoeuvre: 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: Zavanelli manoeuvre

Sample item

In severe shoulder dystocia, McRoberts position, suprapubic pressure, delivery of the posterior arm and rotational manoeuvres have all failed. Which last-resort procedure involves pushing the fetal head back into the vagina so that caesarean section can be performed?

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

The answer and the reasoning

B. Zavanelli manoeuvre

The Zavanelli manoeuvre reverses cardinal movements, flexing and replacing the head into the pelvis, followed by caesarean birth. It is a last resort with high fetal morbidity. Woods and Rubin manoeuvres are internal rotational manoeuvres tried earlier.

Option by option

  • A. Mauriceau-Smellie-Veit manoeuvre

    The Mauriceau-Smellie-Veit manoeuvre delivers the after-coming head of a breech.

  • B. Zavanelli manoeuvre (correct)

    Correct. Cephalic replacement followed by caesarean section is the Zavanelli manoeuvre.

  • C. Lovset manoeuvre

    The Lovset manoeuvre delivers the arms in breech delivery.

  • D. Woods screw manoeuvre

    The Woods screw manoeuvre rotates the posterior shoulder and does not return the head to the pelvis.

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, Zavanelli manoeuvre. The Zavanelli manoeuvre reverses cardinal movements, flexing and replacing the head into the pelvis, followed by caesarean birth.

Why is "Mauriceau-Smellie-Veit manoeuvre" not the answer?

The Mauriceau-Smellie-Veit manoeuvre delivers the after-coming head of a breech.

Why is "Lovset manoeuvre" not the answer?

The Lovset manoeuvre delivers the arms in breech delivery.

Why is "Woods screw manoeuvre" not the answer?

The Woods screw manoeuvre rotates the posterior shoulder and does not return the head to the pelvis.

What concept does this question test?

It tests Labour and delivery: Zavanelli manoeuvre in OBG. It is a last resort with high fetal morbidity. Woods and Rubin manoeuvres are internal rotational manoeuvres tried earlier.

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: Zavanelli manoeuvre?

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.