North American Registry of Midwives (NARM) Practice Exam

If a bimanual exam indicates that a woman's uterus bends backwards at the isthmus, it is classified as?

1. Ante-flexed

2. Retro-flexed

3. Normal position

4. Prolapsed

The correct answer is: Retro-flexed

When a bimanual exam reveals that the woman’s uterus bends backwards at the isthmus, this is characterized as retroflexion. In a retroflexed position, the uterus tilts posteriorly, which can result in it bending towards the rectum instead of the bladder. This condition may occur naturally in some women and can also be related to factors such as pelvic anatomy or conditions like endometriosis. The term "ante-flexed" describes a forward bending of the uterus, which is not applicable in this case. A "normal position" typically refers to the uterus being in an upright or neutral position without significant tilt in either direction, while "prolapsed" refers to the descent of the uterus into the vaginal canal, which is also unrelated to the specific bending of the uterus at the isthmus. Understanding these distinctions helps in accurately identifying uterine positions during clinical assessments.