Stages of Labor: A Comprehensive Guide for Medical Students

Question 1

Which clinical sign marks the commencement of the second stage of labor?

Accepted Answer

Fetal descent with visible perineal bulging

Answer

Cervical dilation of 10 centimeters

Answer

Urinary urgency

Answer

Maternal shivering

Question 2

In the second stage of labor, a fetal heart rate tracing exhibits a sinusoidal pattern with accelerations. What does this tracing most likely indicate?

Accepted Answer

Normal fetal heart rate

Answer

Fetal distress

Answer

Fetal hypoxia

Answer

Fetal tachycardia

Question 3

Which of the following is NOT a cardinal sign of labor's first stage?

Accepted Answer

Irregular uterine contractions

Answer

Cervical effacement

Answer

Cervical dilation

Answer

Show

Question 4

Which of the following is NOT an indication for an episiotomy?

Accepted Answer

Surgeon's preference

Answer

Perineal rigidity

Answer

Imminent delivery of a large baby

Answer

Breech presentation

Question 5

What is the primary physiological mechanism driving cervical dilation during labor's first stage?

Accepted Answer

Oxytocin-induced uterine contractions

Answer

Progesterone withdrawal

Answer

Fetal head pressure

Answer

Amniotic fluid pressure

Question 6

What is the preferred approach for managing a retained placenta?

Accepted Answer

Manual removal under anesthesia

Answer

Oxytocin administration

Answer

Expectant management for up to 24 hours

Answer

Curettage

Question 7

In cases of retained placenta, what is the initial, urgent intervention and why?

Accepted Answer

Immediate manual removal to prevent hemorrhage and infection

Answer

Conservative expectant management to avoid uterine trauma

Answer

Hysterectomy to remove the uterus and retained placenta

Answer

Pharmacological management to stimulate uterine contractions

Question 8

Which hormone primarily triggers the onset of uterine contractions and labor?

Accepted Answer

Oxytocin

Answer

Estrogen

Answer

Progesterone

Answer

Prostaglandins

Question 9

Which finding is a reliable indicator of fetal descent during labor?

Accepted Answer

Decrease in fundal height

Answer

Increased vaginal pressure

Answer

Uterine contractions every 1-2 minutes

Answer

Rupture of membranes

Question 10

What is the most common mechanism of engagement of the fetal head in the pelvis?

Accepted Answer

Vertex presentation

Answer

Asynclitic presentation

Answer

Face presentation

Answer

Breech presentation

Question 11

What is the initial step in the process of placental delivery?

Accepted Answer

Separation of the placenta

Answer

Descent of the placenta

Answer

Delivery of the placenta

Answer

Examination of the placenta

Question 12

Following a vaginal delivery, when is the first postpartum examination typically scheduled?

Accepted Answer

2-3 days

Answer

1 week

Answer

2 weeks

Answer

6 weeks

Question 13

Identify the characteristic NOT associated with the second stage of labor:

Accepted Answer

Full cervical dilation

Answer

Frequent, intensified uterine contractions

Answer

Involuntary urge to push

Answer

Crowning

Question 14

Which of the following is the most reliable indicator of labor onset?

Accepted Answer

Regular uterine contractions occurring at intervals of less than 10 minutes apart

Answer

Show

Answer

Membrane rupture

Answer

Cervical effacement of less than 50%

Question 15

What is the primary goal of the first stage of labor?

Accepted Answer

Cervical dilation to 10 cm to allow for fetal descent

Answer

Fetal descent into the pelvis

Answer

Maternal pushing

Answer

Placental separation

Question 16

What is the primary mechanism by which the placenta separates from the uterine wall in the third stage of labor?

Accepted Answer

Shrinkage of the uterus and detachment of the fetal membranes

Answer

Gravity

Answer

Maternal pushing

Answer

Contraction of the uterus

Question 17

Which of the following is a sign of placental abruption?

Accepted Answer

Dark red vaginal bleeding, abdominal pain, and uterine tenderness

Answer

Bright red vaginal bleeding

Answer

Yellowish vaginal discharge

Answer

Clear or white vaginal discharge

Question 18

What is the most common indication for an episiotomy?

Accepted Answer

To prevent severe perineal lacerations during fetal delivery

Answer

To reduce the risk of postpartum hemorrhage

Answer

To facilitate fetal descent

Question 19

What is the most common cause of postpartum hemorrhage?

Accepted Answer

Uterine atony

Answer

Placental abruption

Answer

Amniotic fluid embolism

Answer

Vaginal or cervical lacerations

Question 20

During the second stage of labor, the fetal heart rate tracing shows a prolonged deceleration pattern. What is the most appropriate initial management strategy?

Accepted Answer

Change maternal position and provide oxygen

Answer

Immediate Cesarean section

Answer

Increase the rate of oxytocin infusion

Answer

Administer tocolytics to stop contractions

Question 21

Which of the following is the initial stage of labor, marked by the effacement and dilation of the cervix?

Accepted Answer

Cervical dilation

Answer

Crowning

Answer

Fetal descent

Answer

Placental delivery

Question 22

Which hormone, produced by the posterior pituitary gland, is primarily responsible for triggering and maintaining uterine contractions during labor?

Accepted Answer

Oxytocin

Answer

Progesterone

Answer

Relaxin

Answer

Estrogen

Question 23

What term refers to the process of thinning and shortening of the cervix, allowing for the passage of the baby's head?

Accepted Answer

Effacement

Answer

Crowning

Answer

Dilatation

Answer

Delivery

Question 24

During labor, the most common fetal position is the one where the baby's head is:

Accepted Answer

Occiput anterior

Answer

Transverse lie

Answer

Occiput posterior

Answer

Breech presentation

Question 25

Which of the following patterns on a fetal heart rate monitor is a concerning sign of potential fetal distress?

Accepted Answer

Late decelerations

Answer

Early decelerations

Answer

Variable decelerations

Answer

Normal baseline heart rate

Question 26

In the event of shoulder dystocia, which maneuver is the primary initial step in the management?

Accepted Answer

McRoberts maneuver

Answer

Cesarean delivery

Answer

Forceps delivery

Answer

Episiotomy

Question 27

When managing postpartum hemorrhage, which intervention should be initiated as the first-line treatment?

Accepted Answer

Uterine massage

Answer

Cesarean hysterectomy

Answer

Blood transfusion

Answer

Pharmacological therapy

Question 28

What is the most common cause of shoulder dystocia?

Accepted Answer

Macrosomia (fetal weight >4,500 grams)

Answer

Maternal obesity

Answer

Breech presentation

Answer

Polyhydramnios

Question 29

What is the primary indication for assisted vaginal delivery (e.g., forceps or vacuum extraction)?

Accepted Answer

Maternal exhaustion or inability to push effectively

Answer

Fetal distress

Answer

Uterine rupture

Answer

Prolonged first stage of labor

Question 30

Which clinical sign is most reliable for assessing cervical dilation during the first stage of labor?

Accepted Answer

Cervical effacement and dilation

Answer

Bloody show

Answer

Uterine contractions

Question 31

At the onset of labor, which fetal position is the most common?

Accepted Answer

Occipito-anterior position (OA)

Answer

Breech presentation

Answer

Occipito-posterior position (OP)

Answer

Face presentation

Question 32

Which hormone is primarily responsible for initiating labor?

Accepted Answer

Oxytocin

Answer

Estrogen

Answer

Prolactin

Answer

Progesterone

Question 33

Which anesthetic technique is most commonly employed for pain management during labor?

Accepted Answer

Epidural analgesia

Answer

Spinal anesthesia

Answer

General anesthesia

Answer

Local anesthesia

Question 34

What is the primary aim of fetal monitoring during labor?

Accepted Answer

To assess fetal and uterine well-being

Answer

To prevent maternal exhaustion

Answer

To predict the onset of labor

Question 35

What is the most common cause of postpartum hemorrhage?

Accepted Answer

Uterine atony

Answer

Placental abruption

Answer

Retained placenta

Answer

Lacerations

Question 36

What is the term for the expulsion of the placenta during the third stage of labor?

Accepted Answer

Placental delivery

Answer

Effacement

Answer

Engagement

Answer

Lightening

Question 37

Which of the following is NOT a clinically significant sign of the onset of labor?

Accepted Answer

Swelling of the cervix

Answer

Cervical dilation

Answer

Uterine contractions

Answer

Show

Question 38

During the second stage of labor, the cervix typically dilates from:

Accepted Answer

6-8 cm to 10 cm

Answer

4-6 cm to 8-10 cm

Answer

2-4 cm to 6-8 cm

Answer

0-4 cm to 6-8 cm

Question 39

The oxytocin challenge test is primarily employed to assess:

Accepted Answer

Fetal well-being and uterine response to oxytocin

Answer

Prediction of labor onset

Answer

Fetal maturity

Question 40

Which of the following is NOT an established indication for induction of labor?

Accepted Answer

Mild preeclampsia

Answer

Chorioamnionitis

Answer

Premature rupture of membranes

Answer

Intrauterine growth restriction

Question 41

The most frequent cause of excessive bleeding following childbirth is:

Accepted Answer

Uterine atony

Answer

Retained placenta

Answer

Vaginal lacerations

Answer

Placental abruption

Question 42

The initial treatment of choice for eclampsia is:

Accepted Answer

Magnesium sulfate

Answer

Hydralazine

Answer

Anticonvulsants

Answer

Nitroglycerin

Question 43

Which of the following is the primary physiological process occurring in the first stage of labor?

Accepted Answer

Cervical dilation

Answer

Placental delivery

Answer

Uterine contractions

Answer

Fetal descent

Question 44

What is the approximate duration of the third stage of labor?

Accepted Answer

5-30 minutes

Answer

1-2 hours

Answer

3-6 hours

Answer

12-24 hours

Question 45

What is the most common fetal presentation in vertex deliveries?

Accepted Answer

Occipito-anterior

Answer

Occipito-posterior

Answer

Frank breech

Question 46

What is the recommended management for a retained placenta?

Accepted Answer

Manual removal under anesthesia

Answer

Uterine massage

Answer

Vacuum extraction

Answer

Expectant management

Question 47

Which of the following describes the transition phase of the first stage of labor?

Accepted Answer

Most rapid cervical dilation

Answer

Lowest pain intensity

Answer

Shortest duration