Operative Obstetrics — MCQs

Q: A multigravida at term with a transverse lie and hand prolapse, along with a fetal heart rate of 140/min, is best managed by:

Cesarean delivery. ***Cesarean delivery*** - A **transverse lie** at term is a contraindication to vaginal delivery, as the fetus cannot pass through the birth canal in this orientation. - The presence of **hand prolapse** further complicates the situation, increasing the risk of umbilical cord prolapse and fetal distress, making cesarean section the safest option. *External cephalic version* - This procedure is performed to change a **breech or transverse lie** to a cephalic presentation, but it is typically done *before* term, usually between 36-37 weeks. - It is contraindicated once labor has started or with **membrane rupture** and fetal parts prolapsed, as is implied by hand prolapse in this term patient. *Breech delivery* - Breech delivery involves the fetus presenting buttocks or feet first, which is not the case here; the presentation is **transverse lie** and **hand prolapse**. - While some breech deliveries can be attempted vaginally under specific circumstances, this patient's presentation makes it an inappropriate option. *Internal podalic version* - This procedure involves changing a **transverse lie** to a **breech presentation** by internal manipulation, often performed in cases of twin delivery for the second twin or in specific scenarios of malpresentation in earlier gestations. - It is rarely performed for a single fetus at term due to risks for both mother and fetus, especially with a **term fetus** and **hand prolapse**.

Practice by Chapter

Cesarean Section Techniques

Practice Questions

Vaginal Birth After Cesarean

Practice Questions

Instrumental Deliveries

Practice Questions

Breech Delivery

Practice Questions

Episiotomy and Repair

Practice Questions

Management of Multiple Gestation

Practice Questions

Cervical Cerclage

Practice Questions

Obstetric Hysterectomy

Practice Questions

Surgery During Pregnancy

Practice Questions

Surgical Complications in Obstetrics

Practice Questions

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free

Scan to download app