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Occiput posterior position — DRCOG MCQ

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ModerateLabourOcciput posterior positionDRCOG

A 29-year-old primigravida has slow progress in labour and severe back pain. Abdominal examination suggests fetal limbs anteriorly and vaginal examination finds the posterior fontanelle towards the sacrum. What is the most likely diagnosis?

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Correct answer: E — Occiput posterior position

Severe back pain with the posterior fontanelle directed towards the sacrum is consistent with occiput posterior position. Face and brow presentations are diagnosed by palpating facial features or brow landmarks. Transverse lie would not present as a cephalic vaginal examination. Shoulder dystocia occurs after delivery of the head, not during first-stage assessment.

Reference: NICE NG235