100 Maternal emergencies after 20 weeks of pregnancy

Question 1

Chronic hypertension in pregnancy is defined as a

Answer 1

Chronic hypertension in pregnancy is defined as a systolic blood
pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg
that existed prior to pregnancy, is diagnosed before the 20th week of
gestation, or persists longer than 12 weeks after delivery.

Question 2

Severe chronce hypertension in pregnancy defined as

Answer 2

Severe chronic
hypertension is systolic blood pressure >160 mm Hg or diastolic pressure
>110 mm Hg.

Question 3

omen with chronic hypertension are at increased

risk for

Answer 3

placental abruption, preeclampsia, low birth weight, cesarean
delivery, premature birth, and fetal demise.2,3

Question 4

Gestational hypertension

Answer 4

hypertension present only after the 20th week of pregnancy or in the immediate postpartum period but without proteinuria.

Question 5

Safe treatment options for hypertensive women who are pregnant

Answer 5

labetalol, methyldopa, nifedipine, and hydralazine.4 All antihypertensive drugs cross the placenta

Question 6

First line agents for chronic hypertension and Price pregnancy with those

Answer 6

Starting dose is 100 mg PO twice a day and the usual maintenance dose is 200 to 400 mg twice per day

Question 7

What drug is usually added when labetalol and methyldopa are not adequately controlling on blood pressure?

Answer 7

Nifedipine.i

Question 8

Medications and doses of acute management of hypertensive emergency and pregnancy

Answer 8

Hydralazine 5 mg IV or IM, labetalol 20 mg IV, or nifedipine 10 to 30 mg PO

Question 9

What is the definition of pre-clamp Sia

Answer 9

Presence of de novo hypertension after 20 weeks of gestation combine with protein urea or other maternal organ dysfunction ( Reno liver neurologic).

Question 10

Severe features of preeclampsia

Answer 10

Systolic blood pressure greater than 160 or diastolic blood pressure greater than 110 on two occasions at least four hours apart. Thrombocytopenia less than 100,000. Impaired liver function tests. Progressive renal insufficiency. Pulmonary Dema. Everybody’s visual disturbances.

Question 11

Medications and doses of acute management of hypertensive emergency and pregnancy

Answer 11

Hydralazine 5 mg IV or IM, labetalol 20 mg IV, or nifedipine 10 to 30 mg PO

Question 12

First line agents for chronic hypertension and Price pregnancy with those

Answer 12

Starting dose is 100 mg PO twice a day and the usual maintenance dose is 200 to 400 mg twice per day

Question 13

What drug is usually added when labetalol and methyldopa are not adequately controlling on blood pressure?

Answer 13

Nifedipine.i

Question 14

Severe features of preeclampsia

Answer 14

Systolic blood pressure greater than 160 or diastolic blood pressure greater than 110 on two occasions at least four hours apart. Thrombocytopenia less than 100,000. Impaired liver function tests. Progressive renal insufficiency. Pulmonary Dema. Everybody’s visual disturbances.

Question 15

Laboratory evaluation for HELLP

Answer 15

CBC with differential, creatinine, LFTs, lactate dehydrogenase, urine protein, protein to creatinine ratio, Uric acid level.

Question 16

Proposed causes of ecclampsia

Answer 16

At hero’s is and thrombosis lead to placental ischemia and infections. Poor placental perfusion is present to lead to the formation of free radicals, actually distress, and inflammatory responses that may influence the mechanistic development of preeclampsia

Question 17

Only treatmeant to prevent preeclampsia and complications

Answer 17

Low-dose aspirin therapy

Question 18

Laboratory abnormalities and help syndrome

Answer 18

Schistocytes on CBC and peripheral smear, platelets less than 100000, lfts mildly elevated, elevated bun and creatinine, elevated ldh and bilirubin

Question 19

Thx for preeclampsia

Answer 19

Prolly outpatient mgmt. reassessments

Question 20

Thx for severe preeclampsia, eclampsia, or Help

Answer 20

Iv mag and anti hypertensives. For eclampsia and help, deliver

Question 21

How to administer iv magnesium

Answer 21

4 to 6 grams given over 20-30 minutes. Then, 2g per hour for at least 24 hours

Question 22

First way to assess vaginal bleeding in the second have a pregnancy

Answer 22

Transvaginal ultrasound to determine the location of the placenta

Question 23

How to diagnose Placental abruption

Answer 23

Diagnosis is mostly clinical. MRIs diagnostic required to transport a potentially unstable patient out of the ED or ICU for imaging

Question 24

What’s worse Vasa previa or placenta previa

Answer 24

Vasa previa is worse because it is seldom recognized Prior to catastrophic vessel disruption during labor. Treatment as rapid operative delivery

Question 25

What is premature rupture of membranes

Answer 25

Rupture of membranes prior to the onset of contractions

Question 26

When is it considered preterm rupture of membranes

Answer 26

Before 37 weeks.

Question 27

How do you manage premature rupture of membranes

Answer 27

Perform speculate emanation visually examine the service to identify dilation and test vaginal fluid. Do not perform digital cervical examination

Question 28

How do you swab or vaginal fluid to determine membeane rupture

Answer 28

Suave the vaginal walls are posterior fornix. Do not swap cervical mucus because it can produce a frowning pattern. Then test with nitrazine paper or pH of 6.5 or blue color. Then look for for ferning under microscopy

Question 29

I when you give steroids for preemies

Answer 29

Between 24 and 34 weeks of gestation.

Question 30

Types of steroids and doses for inducing lung maturity

Answer 30

Betha Methasone 12 mg I am every 12 hours for two days or dexamethasone 6 mg I am every 12 hours for two days

Question 31

Antibiotic regimen for premature preterm member and rupture

Answer 31

Ampicillin to grams IV every six hours and erythromycin 250 mg IV every six hours for 48 hours followed by amoxicillin 250 mg every eight hours and erythromycin base 333 mg every eight hours

Question 32

What antibiotic do you not give for preterm premature rupture of membranes

Answer 32

Do not get Augmentin because it is associated with necrotizing enterocolitis

Question 33

What is the presumed diagnosis in a postpartum woman with fever

Answer 33

Postpartum endometritis. Also considered pneumonia pyelonephritis mastitis from thrombophlebitis and appendicitis

Question 34

Empiric combination for postpartum endometriosis

Answer 34

Clindamycin (900 mg every eight hours IV or 600 mg every six hours IV) and an aminoglycoside (most commonly gentamicin 5 mg per kilogram every 24 hours or 1.5 mg per kilogram every eight hours)

Question 35

What specific lab maybe elevated in Group B streptococci Endometritis

Answer 35

Creatine phosphokinase

Question 36

What is the most common time. For Peripartum cardio myopathy

Answer 36

In the last month of gestation or within the first five months after delivery

Question 37

What is the only medicine in Perry part in cardiomyopathy that is not treated like normal congestive heart failure

Answer 37

Nitroprusside is relatively contraindicated because it can cause a thiocyabate or cyanide accumulation in the fetus

Question 38

Can Warfare in be given in the postpartum period?

Answer 38

Yes it can they poses little rest of the breast-fed infants

Question 39

What is the prognosis for Perry partum cardiomyopathy?

Answer 39

70% of women recover to normal ejection fraction within the first six months postpartum

Question 40

How do you manage premature rupture of membranes

Answer 40

Perform speculate emanation visually examine the service to identify dilation and test vaginal fluid. Do not perform digital cervical examination