Midwifery Exam Questions

Midwifery Exam Questions Related

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Icterus gravis and hydrops fetalis are conditions highly associated with:

  • A. Rhesus D incompatibility
  • B. ABO incompatibility
  • C. Physiological jaundice
  • D. Instant perinatal death
Correct Answer: A

Rationale: The correct answer is A: Rhesus D incompatibility. Icterus gravis (severe jaundice) and hydrops fetalis (abnormal accumulation of fluid) are both conditions commonly associated with Rhesus D incompatibility between a mother and her fetus. This occurs when the mother is Rh-negative and the fetus is Rh-positive, leading to maternal antibodies attacking the fetal red blood cells, resulting in severe hemolytic anemia and subsequent complications.

Explanation for why other choices are incorrect:
B: ABO incompatibility typically leads to less severe jaundice and hemolytic disease compared to Rhesus D incompatibility.
C: Physiological jaundice is a common and benign condition in newborns caused by the immaturity of the liver, not by blood type incompatibility.
D: Instant perinatal death is not specifically associated with these conditions, but rather with other serious complications during childbirth.

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Placenta praevia is also referred to as unavoidable haemorrhage because

  • A. Bleeding results as the segment prepares for true labour
  • B. Bleeding results from pathological processes of the placenta
  • C. Bleeding always occurs after a gestation of 37 complete weeks
  • D. Of the high morbidity and mortality rate to the mother and neonate
Correct Answer: D

Rationale: The correct answer is D because placenta praevia can lead to severe bleeding during childbirth, posing high risks to both the mother and the baby. This condition occurs when the placenta partially or completely covers the cervix, leading to bleeding as the cervix dilates during labor. Choice A is incorrect because bleeding in placenta praevia is not related to the segment preparing for labor. Choice B is incorrect as bleeding is primarily due to the abnormal placement of the placenta, not from pathological processes. Choice C is incorrect as bleeding can occur before 37 weeks in cases of placenta praevia.

In deep transverse arrest,

  • A. The occipito-frontal diameter is caught at the bispinous diameter of the pelvic outlet
  • B. The sub-occipito-bregmatic diameter is caught at the bispinous diameter of pelvic outlet
  • C. The resulting outcome is usually a face to pubis delivery
  • D. The sagittal suture is found at the oblique diameter of the pelvis
Correct Answer: D

Rationale: The correct answer is D because in deep transverse arrest, the sagittal suture of the fetal head is typically aligned with the oblique diameter of the pelvis, causing an obstruction in the descent of the baby. This alignment leads to a difficult labor scenario where the baby's head cannot pass through the pelvis due to the mismatch in diameters. Choices A, B, and C are incorrect because they do not accurately describe the specific anatomical alignment that characterizes deep transverse arrest. Choice A refers to occipito-frontal diameter, choice B refers to sub-occipito-bregmatic diameter, and choice C mentions a face to pubis delivery, which are not the defining features of deep transverse arrest.

What are the main causes of postpartum hemorrhage?

  • A. Uterine atony
  • B. Retained placenta
  • C. Vaginal trauma
  • D. All of the above
Correct Answer: D

Rationale: The correct answer is D, "All of the above." Postpartum hemorrhage can be caused by uterine atony, which is the failure of the uterus to contract after delivery; retained placenta, where parts of the placenta remain in the uterus; and vaginal trauma, such as tears or lacerations during delivery. Each of these factors can contribute to excessive bleeding after childbirth. Therefore, selecting all the choices is necessary to encompass the main causes of postpartum hemorrhage.

In obstructed labor, edema of the vulva presents early due to

  • A. Prolonged effort of the mother to push the baby
  • B. Pressure applied on cervix by the presenting part
  • C. An ill-fitting presenting part pressing on the cervix
  • D. Large presenting diameters stretching the vulva
Correct Answer: B

Rationale: The correct answer is B because pressure applied on the cervix by the presenting part in obstructed labor leads to edema of the vulva. This pressure causes obstruction of blood and lymphatic flow in the area, resulting in swelling and edema. Prolonged effort by the mother (choice A) would not directly cause vulvar edema. An ill-fitting presenting part (choice C) may contribute to obstruction but does not explain the mechanism of edema. Large presenting diameters (choice D) stretching the vulva would not directly cause edema without pressure on the cervix.

Diagnosis of obstructed labour (Abdominal examination):

  • A. Palpation of the abdomen
  • B. Tenderness in the lower abdomen
  • C. Softening of the cervix
  • D. All of the above
Correct Answer: A

Rationale: The correct answer is A: Palpation of the abdomen. To diagnose obstructed labor, palpation of the abdomen is essential to assess the position and size of the fetus, as well as the presence of uterine contractions and fetal heart rate. Tenderness in the lower abdomen may indicate other conditions, not necessarily obstructed labor. Softening of the cervix is a sign of impending labor but not specific to obstructed labor. Therefore, palpation of the abdomen is the most appropriate choice for diagnosing obstructed labor.

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