Free Practice Questions for Esame di Stato Ostetrica

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Key Facts: Esame di Stato Ostetrica Exam

Practical + Thesis

Exam format under Art. 7 D.I. 19 febbraio 2009

Decreto Interministeriale 19 febbraio 2009, Art. 7

L/SNT1

Degree class: Professioni Sanitarie Infermieristiche e Ostetriche

MUR Decreto Interministeriale 19 febbraio 2009

FNOPO

Federazione Nazionale Ordini della Professione Ostetrica under Legge 3/2018

Legge 11 gennaio 2018, n. 3 (Legge Lorenzin)

D.M. 740/1994

Foundational professional profile decree

Ministero della Sanità D.M. 14 settembre 1994, n. 740

varies-by-university

Examination fees and passing thresholds

University Academic Regulations (Regolamenti Didattici di Ateneo)

SNLG-ISS

National Guidelines for Physiological Pregnancy and Birth

Istituto Superiore di Sanità (SNLG)

The qualifying final examination for the Laurea in Ostetricia (L/SNT1) has Esame di Stato value under Article 7 of D.I. 19 febbraio 2009. It combines a profession-specific practical assessment with preparation and discussion of a thesis; local logistics are university-specific. This OpenExamPrep bank is an independent English-language MCQ study adaptation and does not simulate either mandatory component.

Sample Esame di Stato Ostetrica Practice Questions

Try these sample questions to review concepts for the Esame di Stato Ostetrica exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 77+ question experience with AI tutoring.

1A 26-year-old nulliparous woman presents to the consultorio familiare seeking preconception counseling. She has no chronic medical conditions, no prior surgeries, a BMI of 22 kg/m², and takes no medications. According to Italian and international perinatal guidelines, what is the recommended periconceptional folic acid supplementation regimen to prevent neural tube defects?

A.0.4 mg (400 mcg) daily starting at least one month prior to conception and continuing through the first 12 weeks of gestation

B.5.0 mg daily starting as soon as pregnancy is confirmed by a positive urine test and continuing through delivery

C.1.0 mg daily starting in the second trimester once organogenesis is complete

D.0.4 mg (400 mcg) daily initiated exclusively after the first ultrasound confirms an intrauterine pregnancy

Explanation: Italian national guidelines (SNLG-ISS) and international health authorities recommend periconceptional supplementation with 0.4 mg (400 mcg) of oral folic acid daily for all low-risk women planning pregnancy. Supplementation must begin at least one month prior to conception and continue throughout the first 12 weeks of gestation, as the neural tube closes between days 26 and 28 post-conception.

2During a routine second-trimester antenatal visit at 22 weeks of gestation, a healthy 28-year-old primigravida has a blood pressure of 105/65 mmHg and a hemoglobin concentration of 11.2 g/dL. Her baseline blood pressure before conception was 118/75 mmHg and baseline hemoglobin was 13.0 g/dL. What physiological adaptation of pregnancy primarily accounts for these findings?

A.Systemic vasodilation driven by progesterone and nitric oxide lowering systemic vascular resistance, accompanied by disproportionate plasma volume expansion exceeding erythrocyte mass increase

B.Decreased cardiac output and diminished renal perfusion leading to passive hemoconcentration and relative hypotension

C.Pathological fluid sequestration in the third space causing hypovolemia and secondary normocytic anemia

D.Selective placental shunting reducing maternal intravascular volume without altering vascular tone

Explanation: In physiological pregnancy, systemic vascular resistance decreases substantially due to smooth muscle relaxation mediated by progesterone, prostacyclin, and nitric oxide, causing blood pressure to decline during the first two trimesters and reach its nadir around 20-24 weeks. Simultaneously, maternal plasma volume expands by 40-50% while red cell mass increases by only 20-30%, producing the physiological hemodilution (physiologic anemia of pregnancy) reflected in normal hemoglobin levels above 10.5-11.0 g/dL.

3A 24-year-old woman attends her first prenatal appointment at 9 weeks of gestation. According to the Italian national guidelines on physiological pregnancy (Linee Guida Gravidanza Fisiologica SNLG-ISS), which set of routine laboratory investigations should be offered at this initial booking visit?

A.ABO blood typing and Rh(D) factor, indirect Coombs test, complete blood count, rubella IgG, Treponema pallidum serology (TPHA/VDRL), HIV test, and urine culture

B.Karyotype analysis, maternal TORCH panel including cytomegalovirus IgG/IgM, oral glucose tolerance test (OGTT 75g), and pelvic magnetic resonance imaging

C.Serum beta-hCG monitoring every 48 hours, direct Coombs test, toxoplasmosis PCR, and weekly dipstick urinalysis

D.Routine prothrombin time (PT/INR), D-dimer assay, thyroid fine needle aspiration, and cervical elastography

Explanation: The Italian SNLG-ISS guidelines specify that the initial first-trimester booking visit includes ABO and Rh(D) grouping, irregular antibody screening (indirect Coombs test), full blood count, rubella IgG status, screening for syphilis and HIV, and a quantitative urine culture to identify asymptomatic bacteriuria. Routine cytomegalovirus or universal early OGTT without risk factors are not recommended.

4A 30-year-old primigravida is confirmed to have Rh(D)-negative blood type with a negative indirect Coombs test at her initial booking visit. What is the standard evidence-based management protocol during pregnancy according to national Italian guidelines for preventing maternal Rh alloimmunization?

A.Repeat the indirect Coombs test at 28 weeks of gestation, and if still negative, administer anti-D immunoglobulin (1500 IU / 300 mcg) prophylaxis at 28 weeks

B.Administer anti-D immunoglobulin immediately at 12 weeks of gestation and repeat every 4 weeks until term regardless of antibody status

C.Withhold anti-D immunoglobulin entirely during pregnancy and administer it only within 12 hours after birth if the infant is confirmed Rh(D)-negative

D.Perform weekly fetal middle cerebral artery peak systolic velocity Doppler studies starting from 16 weeks without any antibody testing

Explanation: In Rh(D)-negative pregnant women without pre-existing anti-D antibodies (unsensitized), national guidelines recommend repeating the indirect Coombs test at 28 weeks of gestation. If the test remains negative, routine antenatal anti-D prophylaxis (1500 IU / 300 mcg intramuscularly) is administered at 28 weeks to neutralize occult feto-maternal hemorrhage, followed by postnatal administration within 72 hours if the neonate is Rh(D)-positive.

5A 25-year-old pregnant woman at 10 weeks of gestation receives her booking laboratory results showing Rubella IgG < 10 IU/mL (non-immune) and Rubella IgM negative. What is the appropriate clinical advice and management plan provided by the midwife?

A.Advise her to avoid contact with individuals presenting rash or fever, and recommend administration of the live-attenuated MMR vaccine in the immediate postpartum period prior to discharge

B.Administer the measles-mumps-rubella (MMR) vaccine immediately in the clinic to ensure maternal and fetal seroprotection

C.Reassure her that rubella poses no teratogenic risk after the first trimester and that no precautions or postnatal vaccinations are required

D.Prescribe high-dose intravenous immunoglobulin (IVIG) infusions monthly throughout pregnancy to provide passive immunity

Explanation: Rubella vaccine is a live-attenuated virus vaccine and is contraindicated during pregnancy due to the theoretical risk of teratogenicity. Women who are seronegative must be advised on infection avoidance during gestation, and the MMR vaccination should be administered in the immediate postpartum period before discharge from the maternity ward to ensure protection for future pregnancies.

6A nulliparous woman at 8 weeks of gestation is found to be seronegative for Toxoplasma gondii (IgG negative, IgM negative). In accordance with Italian national recommendations, which monitoring schedule and hygiene education should the midwife establish?

A.Repeat Toxoplasma serology every 4 to 6 weeks until delivery, and counsel on consuming only thoroughly cooked meat, washing raw fruits and vegetables carefully, and avoiding direct contact with cat feces or garden soil

B.Repeat serological testing only once at 36 weeks of gestation and restrict dietary dairy products

C.Perform monthly amniocentesis starting at 16 weeks to detect subclinical parasitic transmission in the amniotic fluid

D.Initiate continuous prophylactic oral spiramycin therapy immediately regardless of symptoms

Explanation: In Italy, where toxoplasmosis screening is standard, seronegative pregnant women must be re-tested every 4 to 6 weeks throughout pregnancy to detect acute seroconversion promptly. The midwife must provide targeted lifestyle advice: consume well-cooked meat (internal temperature >66°C), wash raw vegetables and fruits thoroughly with potable water, wear gloves when gardening, and have someone else clean cat litter trays daily.

7A 32-year-old pregnant woman with a pre-pregnancy BMI of 27 kg/m² and a family history of type 2 diabetes in a first-degree relative attends her 24-week antenatal checkup. In accordance with the Italian National Guidelines (SNLG-ISS) for gestational diabetes mellitus (GDM), what is the appropriate screening protocol and diagnostic criteria using the 75g 2-hour oral glucose tolerance test (OGTT)?

A.Perform a 75g 2-hour OGTT at 24-28 weeks; GDM is diagnosed if one or more plasma glucose values meet or exceed: fasting 92 mg/dL, 1-hour 180 mg/dL, or 2-hour 153 mg/dL

B.Perform a 50g non-fasting glucose challenge test (O'Sullivan); if glucose exceeds 140 mg/dL, proceed to a 100g 3-hour test requiring at least two abnormal values

C.Perform a random fingerstick capillary blood glucose test; GDM is diagnosed only if random capillary blood sugar exceeds 200 mg/dL on two occasions

D.Perform a 75g OGTT at 34 weeks; GDM is diagnosed only if all three values (fasting, 1-hour, and 2-hour) are elevated above 140 mg/dL

Explanation: The Italian SNLG-ISS guideline adopts the IADPSG criteria based on the HAPO study. Women at medium risk (e.g., pre-pregnancy BMI >= 25 kg/m², age >= 35, or family history of diabetes) are screened at 24-28 weeks of gestation with a 75g 2-hour OGTT. A diagnosis of GDM is established if even a single venous plasma glucose value is met or exceeded: fasting >= 92 mg/dL (5.1 mmol/L), 1-hour >= 180 mg/dL (10.0 mmol/L), or 2-hour >= 153 mg/dL (8.5 mmol/L).

8A 31-year-old primigravida presents at 36 weeks and 3 days of gestation for routine third-trimester screening. How should the screening for Group B Streptococcus (Streptococcus agalactiae - GBS) be executed according to evidence-based obstetric protocols?

A.Collect a combined lower vaginal and anorectal swab without using a speculum between 36+0 and 37+6 weeks of gestation and culture in selective enrichment broth

B.Perform an endocervical swab using a bivalve speculum at 30 weeks of gestation and culture on non-selective agar

C.Collect a clean-catch midstream urine sample exclusively at 38 weeks; positive GBS screening requires urinary colony counts exceeding 10^7 CFU/mL

D.Perform a maternal nasopharyngeal swab and blood culture at the onset of active labor

Explanation: Universal antenatal culture-based screening for Group B Streptococcus (GBS) is performed at 36+0 to 37+6 weeks of gestation. The correct technique involves taking a single swab (or two swabs) of the lower vaginal introitus and through the anal sphincter (anorectal) without inserting a speculum, followed by inoculation into selective enrichment broth (e.g., Todd-Hewitt or Lim broth) to maximize culture sensitivity.

9A 30-year-old pregnant woman is scheduled for first-trimester combined screening (test combinato) for fetal chromosomal aneuploidies. What are the mandatory biometric prerequisites and biochemical components of this screening test?

A.Ultrasound measurement of fetal nuchal translucency (NT) at crown-rump length (CRL) between 45 mm and 84 mm (11+0 to 13+6 weeks) combined with maternal serum free beta-hCG and PAPP-A

B.Measurement of abdominal circumference at 15-18 weeks combined with maternal serum alpha-fetoprotein (MSAFP) and unconjugated estriol

C.Measurement of biparietal diameter (BPD) at 8-10 weeks combined with maternal serum ferritin and human placental lactogen

D.Measurement of fetal femur length at 14-16 weeks combined with total maternal serum progesterone and inhibin-A

Explanation: The first-trimester combined test (test combinato) integrates maternal age, ultrasound measurement of fetal nuchal translucency (NT) performed when the crown-rump length (CRL) is between 45 mm and 84 mm (corresponding to 11+0 to 13+6 weeks of gestation), and two maternal serum biochemical markers: free beta-human chorionic gonadotropin (free beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A).

10A 34-year-old woman at 12 weeks of gestation asks the midwife about non-invasive prenatal testing (NIPT) utilizing cell-free fetal DNA (cfDNA) in maternal plasma. What crucial clinical principle must the midwife explain during pre-test counseling?

A.NIPT is a high-performance screening test with high sensitivity and specificity for trisomies 21, 18, and 13, but a positive result is not definitive and must be confirmed by diagnostic invasive testing (amniocentesis or CVS)

B.NIPT is a definitive diagnostic genetic test that completely replaces the need for invasive amniocentesis under all circumstances

C.NIPT analyzes intact fetal lymphocytes obtained from maternal circulation to provide a complete 46-chromosome karyotype

D.NIPT has a 100% positive predictive value regardless of maternal age or baseline prior probability

Explanation: Non-invasive prenatal testing (NIPT) analyzes cell-free DNA (primarily derived from placental trophoblast apoptosis) circulating in maternal plasma. While it demonstrates high sensitivity (>99% for trisomy 21) and low false-positive rates, it remains a screening test; because its positive predictive value is less than 100% (partially due to confined placental mosaicism or maternal copy number variations), any abnormal result requires confirmation by invasive diagnostic testing (CVS or amniocentesis) before irreversible clinical decisions are made.

About the Esame di Stato Ostetrica Exam

The Esame di Stato abilitante per Ostetrica/o is the official qualifying examination granting graduates of the Laurea in Ostetricia (Classe L/SNT1 - Professioni Sanitarie Infermieristiche e Ostetriche) legal authorization to practice as registered midwives throughout Italy and enroll in the territorial Ordine della Professione Ostetrica federated under FNOPO (Federazione Nazionale degli Ordini della Professione Ostetrica) pursuant to Legge 3/2018. Governed by Ministerial Decree n. 740 of 14 September 1994, Legge 42/1999, and Legge 251/2000, the midwife is an autonomous healthcare professional specialized in the promotion and maintenance of reproductive health, physiological pregnancy surveillance, independent management of eutocic labor and delivery, postpartum maternal and newborn care, breastfeeding support, gynecological screening, and family planning counseling, as well as the prompt identification and initial management of obstetric emergencies in collaboration with medical specialists. Independent Ostetrica State Exam practice by OpenExamPrep provides an English-language MCQ study adaptation covering antenatal care guidelines, labor mechanics, cardiotocography, neonatal adaptation, postpartum management, obstetric emergency algorithms, and professional deontology.

Exam sponsor: Ministero dell'Università e della Ricerca (MUR) & designated universities with SSN teaching hospitals. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Article 7 of D.I. 19 febbraio 2009 gives the final examination for the Laurea in Ostetricia (L/SNT1) the legal value of an Esame di Stato. The national rule requires two components: a practical examination demonstrating profession-specific theoretical, practical, and technical-operational competence, and preparation and discussion of a thesis. It does not prescribe one national item count, duration, numerical cut score, fee, detailed local task type, or delivery language; candidates must use their university's current notice for those logistics. Independent Ostetrica/o practice by OpenExamPrep is an English-language four-option MCQ study adaptation, not an official translation, a format simulation, or a substitute for practical or oral performance practice.

Time Limit

Varies by university; no single national duration is published

Passing Score

Set by the university; no single national numerical cut score is published

Exam / Certification Fees

Varies by university; no single national fee is published

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25 local questions (not an official percentage)

Physiological Pregnancy Care, Antenatal Screening & Fetal Wellbeing Assessment

Evidence-based antenatal care protocols (Linee Guida Gravidanza Fisiologica SNLG-ISS), routine maternal screening (serology, GCT/OGTT, GBS screening at 36-37 weeks), ultrasound biometry metrics, cardiotocography (CTG FIGO 2015 baseline, variability, accelerations, decelerations), and non-stress test interpretation

22 local questions (not an official percentage)

Physiological Labor, Birth Management, Partogram & Delivery Mechanics

Diagnosis of labor onset, active first stage dynamics, WHO/Italian partogram monitoring, maternal positions, pain relief modalities, pelvic anatomy and cardinal movements of labor, second stage management, perineal protection, episiotomy indications (selective restricted use), physiological third stage, and delayed cord clamping

15 local questions (not an official percentage)

Postpartum & Puerperium Care, Newborn Adaptation & Breastfeeding Promotion

Immediate postpartum observation (two hours post-birth), uterine involution, lochia characteristics, perineal healing (REEDA scale), immediate neonatal adaptation (Apgar score, skin-to-skin contact, thermoregulation), neonatal prophylaxis (vitamin K, ocular prophylaxis), early breastfeeding initiation (WHO/UNICEF Baby-Friendly guidelines, latch mechanics), and puerperal mental health screening (Edinburgh Postnatal Depression Scale)

10 local questions (not an official percentage)

Obstetric Emergencies & Complications

Recognition and acute management of postpartum hemorrhage (PPH 4Ts: tone, tissue, trauma, thrombin; bimanual uterine compression, uterotonic algorithms), hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, HELLP syndrome, magnesium sulfate dosing), shoulder dystocia (HELPERR mnemonic), umbilical cord prolapse, and uterine rupture

5 local questions (not an official percentage)

Gynecological Care, Family Planning, FNOPO Deontology & Healthcare Legislation

Midwifery professional profile (D.M. 740/1994), professional autonomy (Legge 42/1999, Legge 251/2000), professional orders under Legge 3/2018 (FNOPO - Federazione Nazionale degli Ordini della Professione Ostetrica), Codice Deontologico dell'Ostetrica/o, informed consent and privacy (Legge 219/2017, GDPR), family counseling consultorio familiare (Legge 405/1975), voluntary termination of pregnancy (Legge 194/1978), cervical cancer screening (Pap test, HPV-DNA), and contraceptive counseling

Preparing for the Esame di Stato Ostetrica Exam

What You Need to Know

Passing score: Set by the university; no single national numerical cut score is published
Assessment: Article 7 of D.I. 19 febbraio 2009 gives the final examination for the Laurea in Ostetricia (L/SNT1) the legal value of an Esame di Stato. The national rule requires two components: a practical examination demonstrating profession-specific theoretical, practical, and technical-operational competence, and preparation and discussion of a thesis. It does not prescribe one national item count, duration, numerical cut score, fee, detailed local task type, or delivery language; candidates must use their university's current notice for those logistics. Independent Ostetrica/o practice by OpenExamPrep is an English-language four-option MCQ study adaptation, not an official translation, a format simulation, or a substitute for practical or oral performance practice.
Time limit: Varies by university; no single national duration is published
Exam / certification fees: Varies by university; no single national fee is published Official sources

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Esame di Stato Ostetrica: Suggested Study Strategy

1Master the Italian National Guidelines for Physiological Pregnancy (SNLG-ISS Linee Guida Gravidanza Fisiologica), focusing on recommended screening timing (blood type, Coombs test, toxoplasmosis, GDM screening via OGTT 75g at 24-28 weeks, and GBS vagino-rectal swab at 36-37 weeks).

2Gain total fluency in the FIGO 2015 Cardiotocography (CTG) Consensus Guidelines: memorize diagnostic criteria for baseline fetal heart rate (110-160 bpm), normal variability (5-25 bpm), acceleration definitions, and classification of early, late, and prolonged decelerations.

3Understand the cardinal movements of labor in cephalic presentations (engagement, descent, flexion, internal rotation, extension, restitution/external rotation) and the clinical application of the WHO partogram alert and action lines.

4Memorize the systematic management of obstetric emergencies: Postpartum Hemorrhage (the 4Ts etiology, bimanual compression, oxytocin/ergometrine/misoprostol algorithms), Shoulder Dystocia (HELPERR maneuvers starting with McRoberts and suprapubic pressure), and severe preeclampsia (magnesium sulfate loading and maintenance infusion).

5Consolidate neonatal adaptation milestones: Apgar scoring criteria at 1 and 5 minutes, normal physiological vital signs, routine newborn prophylactic care (phytomenadione/vitamin K 1 mg IM, ocular antiseptic), and immediate skin-to-skin thermoregulation.

6Learn the legal architecture of Italian midwifery: D.M. 740/1994 (independent scope of practice in physiological pregnancy and childbirth), Legge 42/1999 (elimination of auxiliary status), Legge 3/2018 (establishment of FNOPO orders), Legge 194/1978 (social protection of motherhood and voluntary termination of pregnancy), and the FNOPO Code of Deontology.

Frequently Asked Questions

What is the legal framework governing the Italian Midwife State Exam (Esame di Stato Ostetrica)?

The qualification is governed by Article 7 of Decreto Interministeriale 19 febbraio 2009 (Determinazione delle classi delle lauree delle professioni sanitarie) in conjunction with Decreto Ministeriale 14 settembre 1994, n. 740 (professional profile of the Midwife / Ostetrica/o). Under Italian law, the final degree examination (prova finale) of the 3-year Laurea in Ostetricia (Classe L/SNT1) has the statutory standing of an Esame di Stato abilitante, qualifying graduates for autonomous professional midwifery practice without needing a separate post-graduate state licensing board.

How is the qualifying examination structured and what are the passing criteria?

Article 7 of D.I. 19 febbraio 2009 requires two components: a practical examination demonstrating profession-specific theoretical, practical, and technical-operational competence, and preparation and discussion of a thesis. Detailed tasks, order, scoring, duration, and delivery arrangements are set by the university rather than standardized nationally.

What professional order must an Italian midwife register with upon passing the exam?

Following the enactment of Legge 11 gennaio 2018, n. 3 (the Lorenzin Health Reform), midwives must register with their territorial Ordine della Professione Ostetrica federated at the national level under FNOPO (Federazione Nazionale degli Ordini della Professione Ostetrica). Registration in the professional register (Albo) is mandatory by law to practice midwifery independently or as an employee in both public hospitals (SSN) and private clinical environments.

What fees are required to sit the examination?

Fees, dates, duration, grading details, and any repeat procedure are set by the individual university. D.I. 19 febbraio 2009 does not publish a single national fee, timetable, duration, or numerical cut score for this final qualifying examination.

What is the legal scope of practice of an autonomous midwife in Italy under D.M. 740/1994?

Under D.M. 740/1994 and related laws (Legge 42/1999, Legge 251/2000), the midwife is an autonomous healthcare professional responsible for: assisting and advising women during pregnancy, labor, and puerperium; independently conducting eutocic physiological deliveries; caring for the healthy newborn; promoting breastfeeding; carrying out preventive gynecological screening and family planning counseling; and promptly identifying pathological conditions requiring obstetrician referral while initiating emergency supportive measures.

Why does OpenExamPrep present practice questions in English multiple-choice format?

D.I. 19 febbraio 2009 does not publish one national delivery language for this university-run final examination. This OpenExamPrep resource uses English four-option MCQs as an independent study adaptation. It is not an official translation, does not simulate the practical examination or thesis defense, and is not a substitute for performance practice or the candidate's university notice.