During an assisted breech birth, the aftercoming head is delivered by placing a finger on the baby's malar bones to flex the head while the other hand presses on the occiput. This is the:

Mauriceau-Smellie-Veit manoeuvre

Before an elective lower segment caesarean section, an indwelling urinary catheter is inserted mainly to:

Keep the bladder empty and away from the incision

Allow the woman to avoid early ambulation

Collect a sterile urine sample for culture

Prevent urinary infection after the operation

In an occipito-posterior position that ends in normal delivery, how far does the occiput rotate anteriorly to come under the symphysis pubis?

Three-eighths of a circle (135°)

A CTG in labour shows a baseline of 150 bpm with reduced variability. With each contraction the fetal heart begins to fall after the contraction has peaked, reaches its lowest point after the peak and recovers only after the contraction ends. This pattern indicates:

Compression of the umbilical cord

During the third stage of labour, which sign shows that the placenta has separated from the uterine wall?

Permanent lengthening of the cord outside the vulva

The uterus becomes broad, soft and flabby

The cord recedes when the uterus is pushed upwards

Vaginal bleeding stops completely

Normal and abnormal labour and obstetric procedures

28 AIIMS NORCET (Nursing Officer) practice questions on Normal and abnormal labour and obstetric procedures, part of Obstetric and Gynaecological Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
During an assisted breech birth, the aftercoming head is delivered by placing a finger on the baby's malar bones to flex the head while the other hand presses on the occiput. This is the:
1. ALovset manoeuvre
2. BMauriceau-Smellie-Veit manoeuvre
3. CBurns-Marshall method
4. DPinard manoeuvre
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Answer: B · Mauriceau-Smellie-Veit manoeuvre
In the Mauriceau-Smellie-Veit manoeuvre the baby lies along the forearm, fingers on the malar bones flex the head, and the other hand on the occiput and shoulders assists while an assistant gives suprapubic pressure. Flexing the head brings its smallest diameter through the pelvis. Controlled, slow delivery of the head avoids sudden decompression and intracranial bleeding. Forceps on the aftercoming head are an alternative.
- A: Lovset is used to free extended arms by rotating the trunk.
- C: Burns-Marshall lets the baby hang and then swings the trunk upward by the feet.
- D: Pinard's manoeuvre brings down the legs in a frank breech.
Question 2 · Medium
Before an elective lower segment caesarean section, an indwelling urinary catheter is inserted mainly to:
1. AAllow the woman to avoid early ambulation
2. BKeep the bladder empty and away from the incision
3. CCollect a sterile urine sample for culture
4. DPrevent urinary infection after the operation
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Answer: B · Keep the bladder empty and away from the incision
The bladder lies directly in front of the lower uterine segment, and the surgeon reflects it down before cutting the uterus. A full bladder blocks access and is easily cut or torn, so it is drained before the incision and kept empty during surgery. The catheter also allows urine output to be measured during and after the operation. It is removed as early as possible, often within 12-24 hours, to reduce infection.
- A: Early ambulation is encouraged after caesarean to prevent thromboembolism.
- C: A urine culture, if needed, is sent separately and is not the reason for catheterisation.
- D: A catheter increases, not prevents, the risk of urinary infection.
Question 3 · Medium
In an occipito-posterior position that ends in normal delivery, how far does the occiput rotate anteriorly to come under the symphysis pubis?
1. ATwo-eighths of a circle (90°)
2. BHalf of a circle (180°)
3. CThree-eighths of a circle (135°)
4. DOne-eighth of a circle (45°)
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Answer: C · Three-eighths of a circle (135°)
In OP positions the occiput lies posteriorly near the sacroiliac joint. With good flexion and contractions it usually turns forward through three-eighths of a circle (long anterior rotation) to lie under the pubis and delivers as an occipito-anterior. In an anterior position the occiput needs to rotate only one-eighth. If it turns one-eighth backward instead, it lies in the hollow of the sacrum and may be born face to pubis.
- A: Two-eighths is the rotation needed from a transverse position.
- B: A half-circle rotation is not the normal mechanism.
- D: One-eighth is the rotation of an occipito-anterior position.
Question 4 · Hard
A CTG in labour shows a baseline of 150 bpm with reduced variability. With each contraction the fetal heart begins to fall after the contraction has peaked, reaches its lowest point after the peak and recovers only after the contraction ends. This pattern indicates:
1. ACompression of the fetal head
2. BUteroplacental insufficiency
3. CA normal fetal sleep cycle
4. DCompression of the umbilical cord
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Answer: B · Uteroplacental insufficiency
A uniform deceleration that starts after the contraction peak and recovers after it ends, recurring with each contraction, is a late deceleration. It reflects poor oxygen delivery across the placenta, and with reduced variability it signals fetal hypoxia and acidosis. Oxytocin is stopped, the woman turned to her left side, hypotension corrected and the obstetrician called. Fetal scalp blood sampling or prompt delivery may follow.
- A: Head compression gives early decelerations that mirror the contraction.
- C: Fetal sleep reduces variability for a short time but does not cause late decelerations.
- D: Cord compression gives variable decelerations of changing shape and timing.
Question 5 · Medium
During the third stage of labour, which sign shows that the placenta has separated from the uterine wall?
1. APermanent lengthening of the cord outside the vulva
2. BThe uterus becomes broad, soft and flabby
3. CThe cord recedes when the uterus is pushed upwards
4. DVaginal bleeding stops completely
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Answer: A · Permanent lengthening of the cord outside the vulva
When the placenta separates and falls into the lower segment, the cord outside the vulva lengthens and stays lengthened. The fundus rises, becomes hard, globular and mobile, and a small gush of blood is common. If the cord recedes when the uterus is pushed up above the pubis, the placenta is still attached. Controlled cord traction is only applied with counter-pressure on the uterus during a contraction.
- B: A broad, flabby uterus is the picture before separation, or of atony.
- C: A cord that draws back on pushing the uterus up shows the placenta is still attached.
- D: A small gush of blood, not complete arrest of bleeding, accompanies separation.
Question 6 · Hard
A woman with regular 28-day cycles had her last menstrual period on 1 January 2026. Her unit offers induction of labour at 41 completed weeks. On which date does she reach 41 weeks?
1. A22 October 2026
2. B8 October 2026
3. C1 October 2026
4. D15 October 2026
Answer and explanation in LearnFree account
Question 7 · Easy
The most common position of the fetus in a vertex presentation is:
1. ARight occipito-posterior
2. BRight occipito-anterior
3. CLeft occipito-anterior
4. DLeft occipito-transverse
Answer and explanation in LearnFree account
Question 8 · Easy
While help is coming for a woman with a prolapsed umbilical cord, the nurse should place her in the:
1. ASupine position
2. BKnee-chest position
3. CSemi-Fowler's position
4. DLithotomy position
Answer and explanation in LearnFree account
Question 9 · Easy
In the WHO Labour Care Guide (2020), the active first stage of labour begins at a cervical dilatation of:
1. A5 cm
2. B3 cm
3. C7 cm
4. D4 cm
Answer and explanation in LearnFree account
Question 10 · Medium
A para 4 has been in labour for 20 hours with a large baby; she is dehydrated, with a pulse of 120/min, the lower uterine segment is tender and caput is marked. If labour is not relieved, the most likely complication is:
1. AInversion of the uterus
2. BRupture of the uterus
3. CPlacenta accreta
4. DAmniotic fluid embolism
Answer and explanation in LearnFree account
Question 11 · Hard
Oxytocin 5 IU is added to 500 mL of Ringer's lactate, and the order is to start at 2 milliunits per minute. At what rate should the infusion pump be set?
1. A24 mL/hour
2. B120 mL/hour
3. C6 mL/hour
4. D12 mL/hour
Answer and explanation in LearnFree account
Question 12 · Hard
Before induction, a woman's cervix is 2 cm dilated, 60% effaced, soft and mid-position, with the head at station -1. Using the Bishop score (dilatation, effacement, station, consistency and position), what is her score?
1. A6
2. B9
3. C8
4. D7
Answer and explanation in LearnFree account
Question 13 · Easy
In a well-flexed vertex presentation, the diameter of the fetal head that engages is the:
1. AMentovertical, 13.5 cm
2. BSubmentobregmatic, 9.5 cm
3. CSuboccipitobregmatic, 9.5 cm
4. DOccipitofrontal, 11.5 cm
Answer and explanation in LearnFree account
Question 14 · Medium
At a primary health centre, the cervical dilatation of a woman in active labour is plotted to the right of the alert line on the WHO modified partograph. The nurse's correct action is to:
1. ARefer her to a facility that can do caesarean section
2. BStart oxytocin augmentation at the health centre
3. CPerform artificial rupture of membranes and wait
4. DContinue recording at the same intervals without change
Answer and explanation in LearnFree account
Question 15 · Medium
Just after artificial rupture of membranes, a loop of cord is seen at the vulva and the fetal heart rate falls to 90/min. Which action should the nurse take first while help is called?
1. APush the presenting part up off the cord with gloved fingers
2. BStart an oxytocin infusion to hasten the birth
3. CPush the cord back into the uterus above the head
4. DWrap the cord in a dry gauze and pull it outwards
Answer and explanation in LearnFree account
Question 16 · Hard
A primigravida has been in the second stage for 3 hours with an epidural. The cervix is fully dilated, membranes ruptured, head OA at station +2 and fetal heart normal; outlet forceps are planned. What must the nurse ensure just before the blades are applied?
1. AAn oxytocin bolus has been given IV
2. BThe woman is turned to the left lateral
3. CFundal pressure is ready to aid traction
4. DThe bladder has been emptied by catheter
Answer and explanation in LearnFree account
Question 17 · Medium
A woman wishes to attempt a vaginal birth after a previous caesarean section. Which previous uterine incision is a contraindication to a trial of labour?
1. ALower segment incision done three years ago
2. BLower segment incision done for breech
3. CLower segment transverse incision
4. DClassical upper segment vertical incision
Answer and explanation in LearnFree account
Question 18 · Medium
When is an episiotomy usually performed in a woman giving birth with a vertex presentation?
1. AAt the start of the second stage, before descent
2. BWhen the perineum is thinned and the head distends it
3. CAfter the head has been born, before the shoulders
4. DAs soon as the cervix is found fully dilated
Answer and explanation in LearnFree account
Question 19 · Medium
The fetal head is delivered but retracts tightly against the perineum and the shoulders do not deliver with gentle traction. After calling for help, the first manoeuvre the team should use is:
1. AZavanelli manoeuvre
2. BFundal pressure
3. CWoods screw manoeuvre
4. DMcRoberts manoeuvre
Answer and explanation in LearnFree account
Question 20 · Easy
The Bishop score is used to assess:
1. AAdequacy of the maternal pelvis
2. BFetal wellbeing in a high-risk pregnancy
3. CReadiness of the cervix for induction
4. DCondition of the newborn at birth
Answer and explanation in LearnFree account
Question 21 · Hard
On a WHO modified partograph, a woman is 4 cm dilated at 08:00, plotted on the alert line. At 12:00 her cervix is 6 cm. Where does the 12:00 point lie?
1. ARight of the alert line, left of the action line
2. BTo the left of the alert line
3. COn the alert line, showing normal progress
4. DTo the right of the action line
Answer and explanation in LearnFree account
Question 22 · Medium
Which presentation has the largest presenting diameter of the fetal head and usually cannot deliver vaginally with a term-size baby?
1. AComplete breech presentation
2. BDeflexed vertex presentation
3. CBrow presentation
4. DFace presentation
Answer and explanation in LearnFree account
Question 23 · Hard
The anterior shoulder of a large baby is stuck after the head is delivered. One doctor holds the mother's thighs flexed and another applies pressure above the pubis; a third person starts pushing hard on the top of the uterus. What should the nurse do first?
1. AStop the doctor applying suprapubic pressure
2. BPull the baby's head downward firmly
3. CLower the mother's legs to lithotomy
4. DStop the person pushing on the fundus
Answer and explanation in LearnFree account
Question 24 · Medium
In the mechanism of normal labour with an occipito-anterior vertex, which movement of the head follows immediately after its birth by extension?
1. AExternal rotation
2. BInternal rotation
3. CRestitution
4. DCrowning
Answer and explanation in LearnFree account
Question 25 · Easy
In obstructed labour, the appearance of Bandl's ring across the abdomen indicates:
1. ASeparation of the placenta
2. BNormal progress in the second stage
3. CIncompetence of the cervix
4. DImpending rupture of the uterus
Answer and explanation in LearnFree account

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Normal and abnormal labour and obstetric procedures

During an assisted breech birth, the aftercoming head is delivered by placing a finger on the baby's malar bones to flex the head while the other hand presses on the occiput. This is the:

Before an elective lower segment caesarean section, an indwelling urinary catheter is inserted mainly to:

In an occipito-posterior position that ends in normal delivery, how far does the occiput rotate anteriorly to come under the symphysis pubis?

A CTG in labour shows a baseline of 150 bpm with reduced variability. With each contraction the fetal heart begins to fall after the contraction has peaked, reaches its lowest point after the peak and recovers only after the contraction ends. This pattern indicates:

During the third stage of labour, which sign shows that the placenta has separated from the uterine wall?

A woman with regular 28-day cycles had her last menstrual period on 1 January 2026. Her unit offers induction of labour at 41 completed weeks. On which date does she reach 41 weeks?

The most common position of the fetus in a vertex presentation is:

While help is coming for a woman with a prolapsed umbilical cord, the nurse should place her in the:

In the WHO Labour Care Guide (2020), the active first stage of labour begins at a cervical dilatation of:

A para 4 has been in labour for 20 hours with a large baby; she is dehydrated, with a pulse of 120/min, the lower uterine segment is tender and caput is marked. If labour is not relieved, the most likely complication is:

Oxytocin 5 IU is added to 500 mL of Ringer's lactate, and the order is to start at 2 milliunits per minute. At what rate should the infusion pump be set?

Before induction, a woman's cervix is 2 cm dilated, 60% effaced, soft and mid-position, with the head at station -1. Using the Bishop score (dilatation, effacement, station, consistency and position), what is her score?

In a well-flexed vertex presentation, the diameter of the fetal head that engages is the:

At a primary health centre, the cervical dilatation of a woman in active labour is plotted to the right of the alert line on the WHO modified partograph. The nurse's correct action is to:

Just after artificial rupture of membranes, a loop of cord is seen at the vulva and the fetal heart rate falls to 90/min. Which action should the nurse take first while help is called?

A primigravida has been in the second stage for 3 hours with an epidural. The cervix is fully dilated, membranes ruptured, head OA at station +2 and fetal heart normal; outlet forceps are planned. What must the nurse ensure just before the blades are applied?

A woman wishes to attempt a vaginal birth after a previous caesarean section. Which previous uterine incision is a contraindication to a trial of labour?

When is an episiotomy usually performed in a woman giving birth with a vertex presentation?

The fetal head is delivered but retracts tightly against the perineum and the shoulders do not deliver with gentle traction. After calling for help, the first manoeuvre the team should use is:

The Bishop score is used to assess:

On a WHO modified partograph, a woman is 4 cm dilated at 08:00, plotted on the alert line. At 12:00 her cervix is 6 cm. Where does the 12:00 point lie?

Which presentation has the largest presenting diameter of the fetal head and usually cannot deliver vaginally with a term-size baby?

The anterior shoulder of a large baby is stuck after the head is delivered. One doctor holds the mother's thighs flexed and another applies pressure above the pubis; a third person starts pushing hard on the top of the uterus. What should the nurse do first?

In the mechanism of normal labour with an occipito-anterior vertex, which movement of the head follows immediately after its birth by extension?

In obstructed labour, the appearance of Bandl's ring across the abdomen indicates: