maternal and newborn

Question 1

Umbilical
cord
prolapse

● Variable decelerations
● Visible or palpable cord
Polyhydramnios: Excess amniotic fluid creates a larger gush
when membranes rupture.
Malpresentation (breech, transverse): Extra space around
the presenting part makes it easier for the cord to slip through
the cervix.

Answer 1

● Lift presenting part off cord with
sterile gloved hand.
● Position knees-to-chest or in
Trendelenburg.
Call for assistance.
3. Administer oxygen 10 L/min via nonrebreather.
4. Prepare for emergency cesarean delivery.

Question 2

Shoulder
dystocia

● “Turtle” sign (fetal head
retracts after it emerges)

Answer 2

● Perform McRoberts maneuver (flex
maternal thighs against abdomen).
● Apply suprapubic pressure.

Question 3

Amniotic
fluid
embolism catastrophic event in
which amniotic fluid enters the maternal bloodstream,
triggering an anaphylaxis-like response

● Sudden maternal
respiratory distress
and hypotension
Can progress to disseminated intravascular
coagulation (DIC): Widespread clotting depletes
clotting factors  Widespread bleeding
Bleeding from VAD sites and petechiae
Cardiac arrest

Answer 3

● Call rapid response team.
● Administer 100% oxygen and
prepare for intubation.
● Initiate IV fluids and vasopressors.
Prepare for emergent cesarean delivery to
improve maternal-fetal survival.

Question 4

Uterine
rupture

● Sudden abdominal pain
● Cessation of contractions

Answer 4

● Administer oxygen.
● Initiate IV fluids and blood products.
● Prepare for emergency cesarean.