Labour: occipitoposterior position: 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: occipitoposterior position

Sample item

In a persistent occipitoposterior position, delivery typically occurs by which mechanism?

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

The answer and the reasoning

D. Long internal rotation or face-to-pubis delivery

In OP position the occiput rotates 135 degrees anteriorly (long rotation) in most cases. If the head fails to rotate it delivers face to pubes, requiring more room and a prolonged labour with back pain. Manual rotation or instrumental rotation is options.

Option by option

  • A. Breech extraction

    Breech extraction is not applicable.

  • B. Spontaneous 45-degree rotation anteriorly

    A 45-degree rotation describes occipitoanterior position, not OP.

  • C. Always by caesarean section

    Many OP babies deliver vaginally.

  • D. Long internal rotation or face-to-pubis delivery (correct)

    Correct. Long rotation or direct OP delivery are the possible mechanisms.

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 D, Long internal rotation or face-to-pubis delivery. In OP position the occiput rotates 135 degrees anteriorly (long rotation) in most cases.

Why is "Breech extraction" not the answer?

Breech extraction is not applicable.

Why is "Spontaneous 45-degree rotation anteriorly" not the answer?

A 45-degree rotation describes occipitoanterior position, not OP.

Why is "Always by caesarean section" not the answer?

Many OP babies deliver vaginally.

What concept does this question test?

It tests Labour: occipitoposterior position in OBG. If the head fails to rotate it delivers face to pubes, requiring more room and a prolonged labour with back pain. Manual rotation or instrumental rotation is options.

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: occipitoposterior position?

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.