Labour and delivery: malposition: 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: malposition

Sample item

A nulliparous woman in labour has severe backache, early urge to push and slow descent. The abdomen is flat in the lower half and the fetal heart is heard in the flank. What is the most likely cause?

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

The answer and the reasoning

A. Occipitoposterior position

In an occipitoposterior position, the fetal head presses on the sacrum, causing back pain, and the larger deflexed head descends slowly. The abdomen appears flat or saucer shaped and fetal limbs are felt anteriorly. Most rotate forward to deliver.

Option by option

  • A. Occipitoposterior position (correct)

    Correct. The back pain, flat abdomen and slow descent are typical.

  • B. Brow presentation

    Brow gives a high head and obstructed descent, with no such abdominal findings.

  • C. Occipitotransverse arrest

    Transverse arrest stops at the level of the ischial spines but does not cause this picture.

  • D. Deflexed breech

    A breech is not suggested by a fetal heart in the flank.

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 A, Occipitoposterior position. In an occipitoposterior position, the fetal head presses on the sacrum, causing back pain, and the larger deflexed head descends slowly.

Why is "Brow presentation" not the answer?

Brow gives a high head and obstructed descent, with no such abdominal findings.

Why is "Occipitotransverse arrest" not the answer?

Transverse arrest stops at the level of the ischial spines but does not cause this picture.

Why is "Deflexed breech" not the answer?

A breech is not suggested by a fetal heart in the flank.

What concept does this question test?

It tests Labour and delivery: malposition in OBG. The abdomen appears flat or saucer shaped and fetal limbs are felt anteriorly. Most rotate forward to deliver.

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: malposition?

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.