Q.1 Which of the following is the most common cause of postpartum hemorrhage?
Uterine atony
Retained placenta
Genital tract trauma
Coagulation disorders
Explanation - Uterine atony accounts for around 70–80% of postpartum hemorrhage cases as the uterus fails to contract effectively after delivery.
Correct answer is: Uterine atony
Q.2 Lochia rubra is expected during which postpartum days?
Day 1–4
Day 5–9
Day 10–14
After 3 weeks
Explanation - Lochia rubra, which is bright red discharge, occurs in the first 3–4 days postpartum before changing to lochia serosa.
Correct answer is: Day 1–4
Q.3 Which vitamin should be supplemented in exclusively breastfeeding mothers to prevent deficiency in infants?
Vitamin A
Vitamin D
Vitamin C
Vitamin K
Explanation - Breast milk is deficient in Vitamin D, so supplementation is needed to prevent rickets in infants.
Correct answer is: Vitamin D
Q.4 What is the recommended first-line treatment for mastitis in breastfeeding women?
Stop breastfeeding
Apply cold compresses only
Continue breastfeeding and start antibiotics
Wean the baby immediately
Explanation - Mastitis is commonly caused by Staphylococcus aureus, and treatment includes antibiotics while continuing breastfeeding to prevent milk stasis.
Correct answer is: Continue breastfeeding and start antibiotics
Q.5 Which hormone is primarily responsible for lactogenesis?
Oxytocin
Prolactin
Estrogen
Progesterone
Explanation - Prolactin stimulates milk production from alveolar cells, while oxytocin aids in milk ejection.
Correct answer is: Prolactin
Q.6 Postpartum blues usually resolve within:
1–2 days
1–2 weeks
1–2 months
More than 3 months
Explanation - Postpartum blues are mild mood disturbances that resolve within 1–2 weeks without medical intervention.
Correct answer is: 1–2 weeks
Q.7 Which of the following is a contraindication to breastfeeding?
Maternal HIV infection (untreated)
Cesarean section delivery
Maternal anemia
Mastitis
Explanation - Untreated HIV is a contraindication due to transmission risk; however, mastitis and cesarean section are not absolute contraindications.
Correct answer is: Maternal HIV infection (untreated)
Q.8 Which pelvic floor complication is most common in the postpartum period?
Urinary incontinence
Anal fissures
Rectal carcinoma
Ovarian cysts
Explanation - Pelvic floor trauma during delivery often causes urinary incontinence, especially stress incontinence.
Correct answer is: Urinary incontinence
Q.9 What is the primary role of oxytocin in postpartum care?
Milk production
Milk ejection reflex
Endometrial regeneration
Menstrual cycle resumption
Explanation - Oxytocin is responsible for milk letdown and uterine contraction, but prolactin regulates milk production.
Correct answer is: Milk ejection reflex
Q.10 Which of the following is the strongest risk factor for postpartum depression?
Primiparity
History of depression
Cesarean section
Breastfeeding difficulties
Explanation - A past history of depression is the strongest predictor for postpartum depression.
Correct answer is: History of depression
Q.11 What is the most appropriate time for postpartum checkup after vaginal delivery?
1 week
2 weeks
4–6 weeks
3 months
Explanation - The standard postpartum checkup is scheduled around 4–6 weeks after delivery to assess recovery.
Correct answer is: 4–6 weeks
Q.12 Which of the following is the leading cause of maternal mortality in the postpartum period worldwide?
Sepsis
Hemorrhage
Thromboembolism
Hypertensive disorders
Explanation - Postpartum hemorrhage is the leading cause of maternal death globally, especially in low-resource settings.
Correct answer is: Hemorrhage
Q.13 Which non-pharmacological intervention helps reduce perineal pain after vaginal delivery?
Hot compresses
Sitz baths
Excessive ambulation
Tight undergarments
Explanation - Sitz baths with warm water provide perineal pain relief and promote healing.
Correct answer is: Sitz baths
Q.14 What is the recommended contraception immediately postpartum in breastfeeding women?
Combined oral contraceptives
Progestin-only pills
Copper IUD after 6 weeks
Barrier methods only
Explanation - Progestin-only methods are safe in breastfeeding women, while combined OCPs may affect milk supply early.
Correct answer is: Progestin-only pills
Q.15 Which sign suggests secondary postpartum hemorrhage?
Bleeding within 12 hours of delivery
Bleeding after 24 hours up to 6 weeks postpartum
Lochia rubra
Breast engorgement
Explanation - Secondary postpartum hemorrhage occurs between 24 hours and 6 weeks postpartum, usually due to retained products or infection.
Correct answer is: Bleeding after 24 hours up to 6 weeks postpartum
Q.16 What is the first-line management for postpartum endometritis?
Oral antibiotics
IV broad-spectrum antibiotics
Uterine curettage
Observation only
Explanation - Endometritis requires prompt IV broad-spectrum antibiotics such as clindamycin plus gentamicin.
Correct answer is: IV broad-spectrum antibiotics
Q.17 Which hormone decreases significantly after delivery to allow lactation?
Prolactin
Oxytocin
Estrogen
Cortisol
Explanation - The fall in estrogen and progesterone after delivery removes inhibition on prolactin, allowing lactation.
Correct answer is: Estrogen
Q.18 Which complication is more common after cesarean section compared to vaginal delivery?
Uterine rupture
Postpartum hemorrhage
Endometritis
Urinary incontinence
Explanation - Endometritis is more common after cesarean due to increased risk of infection in surgical wounds.
Correct answer is: Endometritis
Q.19 The uterus is normally non-palpable abdominally by how many weeks postpartum?
2 weeks
4 weeks
6 weeks
8 weeks
Explanation - By 2 weeks postpartum, the uterus has involuted enough to be non-palpable abdominally.
Correct answer is: 2 weeks
Q.20 Which of the following is the safest analgesic during breastfeeding?
Aspirin
Ibuprofen
Codeine
Tramadol
Explanation - Ibuprofen is safe during lactation due to minimal secretion in breast milk, unlike aspirin and opioids.
Correct answer is: Ibuprofen
Q.21 What is the major risk factor for postpartum venous thromboembolism?
Multiparity
Obesity
Prolonged labor
Breastfeeding
Explanation - Obesity and immobility are strong risk factors for postpartum venous thromboembolism.
Correct answer is: Obesity
Q.22 Which immunization is commonly given in the immediate postpartum period if not received during pregnancy?
BCG
MMR
Polio
Varicella
Explanation - MMR is a live vaccine contraindicated in pregnancy but safe postpartum if the mother is non-immune.
Correct answer is: MMR
Q.23 What is the most common cause of fever in the first 24 hours postpartum?
Urinary tract infection
Breast engorgement
Endometritis
Dehydration
Explanation - Breast engorgement is the most common cause of postpartum fever within the first 24 hours.
Correct answer is: Breast engorgement
Q.24 Which type of lochia is yellowish or whitish and occurs after 10–14 days postpartum?
Lochia rubra
Lochia serosa
Lochia alba
Pathological lochia
Explanation - Lochia alba is whitish/yellowish and occurs around 2–6 weeks postpartum, signifying the final stage of lochia.
Correct answer is: Lochia alba
Q.25 What is the best management of cracked nipples in breastfeeding women?
Stop breastfeeding
Apply soap and water frequently
Correct latching technique
Switch to bottle feeding
Explanation - The most effective way to prevent and manage cracked nipples is ensuring proper latch during breastfeeding.
Correct answer is: Correct latching technique