Free Obstetric Emergencies MCQs with Answers

• A. Apply firm pressure over the lower abdomen
• B. Massage the uterine fundus and call for help
• C. Insert a urinary catheter without further assessment
• D. Place an ice pack over the perineum

Explanation: A boggy uterus suggests uterine atony, a common cause of postpartum haemorrhage.

• A. Restrain her arms and legs firmly
• B. Place a spoon between her teeth
• C. Turn her to the side and protect her from injury
• D. Give oral fluids after opening her mouth

Explanation: The immediate priorities are airway protection, prevention of injury, and maintaining maternal oxygenation.

• A. Continue the infusion and reassess in 30 minutes
• B. Stop magnesium sulfate and prepare calcium gluconate
• C. Give an additional dose of magnesium sulfate
• D. Encourage deep breathing and offer oral fluids

Explanation: Absent reflexes and respiratory depression indicate magnesium sulfate toxicity.

• A. Push the cord back into the vagina
• B. Lift the presenting part with a gloved hand
• C. Ask the woman to bear down strongly
• D. Apply fundal pressure to speed the birth

Explanation: The presenting part may compress a prolapsed cord and reduce fetal oxygenation.

• A. Apply strong downward traction to the head
• B. Apply fundal pressure above the uterus
• C. Place the woman in the McRoberts position
• D. Ask the woman to walk around the room

Explanation: McRoberts positioning, with marked flexion of the maternal hips, is the first manoeuvre for shoulder dystocia.

• A. Placenta previa
• B. Uterine rupture
• C. Uncomplicated false labour
• D. Mild pregnancy-induced hypertension

Explanation: Sudden pain, loss of effective contractions, fetal bradycardia, and maternal compromise are warning signs of uterine rupture.

• A. Give high-flow oxygen and activate the emergency response
• B. Offer oral fluids and place her in a sitting position
• C. Administer an oral analgesic and reassess her pain
• D. Encourage her to walk to improve circulation

Explanation: The sudden respiratory and circulatory collapse may indicate amniotic fluid embolism.

• A. Turn her to a lateral position
• B. Increase the oxytocin infusion rate
• C. Ask her to lie flat on her back
• D. Encourage prolonged pushing with each contraction

Explanation: A lateral position improves uteroplacental blood flow and is an immediate response to suspected fetal compromise.

• A. Insert two large-bore intravenous cannulas
• B. Give an oral iron tablet with water
• C. Keep her sitting upright without monitoring
• D. Delay treatment until the haemoglobin result returns

Explanation: The findings indicate hypovolaemic shock, so rapid vascular access is needed for isotonic fluids, blood products, and emergency medicines.

• A. Arrange urgent referral while continuing resuscitation
• B. Send her home after advising bed rest
• C. Wait for bleeding to stop before contacting a referral centre
• D. Transfer her without intravenous access or monitoring

Explanation: Persistent postpartum haemorrhage requires urgent referral to a facility with blood products, surgery, and specialist obstetric care.

• A. Continue uterine massage for another 30 minutes
• B. Inspect the birth canal and prepare for laceration repair
• C. Apply firm pressure over the woman’s lower abdomen
• D. Give oral fluids and reassess the bleeding later

Explanation: A firm uterus with ongoing bright-red bleeding suggests trauma to the cervix, vagina, or perineum rather than uterine atony.

• A. Encourage breastfeeding to increase uterine contraction
• B. Prepare the woman for urgent controlled manual removal
• C. Apply an abdominal binder and observe the blood loss
• D. Ask the woman to walk to help deliver the placenta

Explanation: An undelivered placenta with ongoing bleeding may cause severe postpartum haemorrhage and requires urgent obstetric management.

• A. Pull gently on the visible mass to remove it
• B. Call for emergency help and prepare for uterine replacement
• C. Massage the abdomen until the mass disappears
• D. Place the woman upright and offer clear fluids

Explanation: The findings indicate uterine inversion, which can cause rapid haemorrhagic shock.

• A. Oxytocin
• B. Misoprostol
• C. Methylergonovine
• D. Tranexamic acid

Explanation: Methylergonovine causes strong uterine contraction and systemic vasoconstriction, so it is avoided in severe hypertension.

• A. Oxytocin
• B. Carboprost
• C. Misoprostol
• D. Tranexamic acid

Explanation: Carboprost can cause bronchospasm and is avoided or used with great caution in women with asthma.

• A. Preparation for emergency laparotomy and birth
• B. Preparation for a routine vaginal examination
• C. Administration of oral analgesia and reassessment
• D. Encouragement of pushing with the next contraction

Explanation: Suspected uterine rupture is a life-threatening obstetric emergency requiring immediate surgical management and resuscitation.

• A. Turn her to the left lateral position and call for urgent review
• B. Place her flat on her back and increase the analgesic dose
• C. Ask her to push strongly during the next contraction
• D. Offer oral fluids and continue routine fetal monitoring

Explanation: Maternal hypotension can reduce uteroplacental perfusion and cause fetal bradycardia.

• A. Left lateral position with appropriate leg support
• B. Fully upright position with the legs hanging down
• C. Prone position with the abdomen unsupported
• D. Flat supine position with a pillow under the neck

Explanation: The enlarged uterus can compress the inferior vena cava when the woman lies flat, reducing venous return and cardiac output.

• A. Mild ankle oedema after prolonged standing
• B. Persistent oozing from several puncture sites
• C. A small amount of lochia after vaginal birth
• D. A soft abdomen with occasional uterine cramps

Explanation: Persistent oozing from venepuncture sites suggests consumption of clotting factors and platelets, as occurs in disseminated intravascular…

• A. Give the next dose and increase the infusion rate
• B. Withhold the next dose and notify the prescriber
• C. Give an additional dose to prevent another seizure
• D. Encourage oral fluids and document the finding later

Explanation: Magnesium sulfate is eliminated by the kidneys, so low urine output increases the risk of accumulation and toxicity even before…