OB Emergencies abnormal deliveries

Question 1

The most common cause of vaginal bleeding during pregnancy is?

Answer 1

Abortion/miscarriage

Question 2

The expulsion of the fetus prior to 20 weeks gestation. Also called a miscarriage.

Answer 2

Abortion

Question 3

Vaginal bleeding with clots and tissue, cramping abdominal pain or backache. If it is late in the first trimester or later, a fetus may be passed which may remain attached by the umbilical cord.

Answer 3

Signs and symptoms of a spontaneous abortion

Question 4

Abnormal implantation of fertilized egg outside of he uterus.

Answer 4

Ectopic pregnancy

Question 5

Abdominal pain, diffuse tenderness moving to specific unilateral sharp pain lower abdominal quadrant. Missing a period, decreased menstrual flow with brownish color, shorter in duration. A rigid abdomen may be present and pain may be referred to a shoulder on the affected side. Vaginal bleeding, signs of shock/hypoperfusion along with syncope may be present.

Answer 5

Signs and symptoms of a ectopic pregnancy

Question 6

Placenta implants on the lower half of the uterus, either partially or completely blocking the cervical opening.

Answer 6

Placenta previa

Question 7

Signs and symptoms of a placenta previa Bright red vaginal bleeding without pain. May be spotting or recurrent hemorrhage. May be precipitated by recent intercourse or vaginal examination and is normally seen in the third trimester.

Answer 7

Signs and symptoms of a placenta previa

Question 8

Premature separation of the placenta from the uterine wall.

Answer 8

Abruptio placenta

Question 9

Vaginal bleeding may be present or may not be depending on the location of separation. Sudden sharp tearing pain and a stiff, board-like abdomen. If complete separation occurs, significant hemorrhage and hypoperfusion/shock will occur. This may occur during labor.

Answer 9

Signs and symptoms of abruptio placenta

Question 10

Increase in systolic blood pressure by 30 mmHg and/or a diastolic increase by 15 mmHg over patient’s baseline on two occasions within a 6 hour time period and protein in patient’s urine (damage to organs). Occurs after 20 weeks of gestation, most commonly seen in the last trimester and may rarely occur postpartum.

Answer 10

Preeclampsia

Question 11

Signs and symptoms of preeclampsia Hypertension, edema, headache, visual disturbances, pulmonary edema, and significant decrease in urine output.

Answer 11

Signs and symptoms of preeclampsia

Question 12

Generalized tonic-clonic seizures in a patient who is pregnant and likely has a history of preeclampsia.

Answer 12

Eclampsia

Question 13

Seizures that may be preceded by visual disturbances (flashing lights or dark spots). Pain in the epigastric or right upper abdominal quadrant may also precede a seizure. Edema and hypertension are likely present.

Answer 13

Signs and symptoms of eclampsia

Question 14

Intermittent contraction of the uterus that are painless with no dilation or effacement (thinning/shortening) of the cervix. This sometimes termed “false labor”. Virtually impossible to distinguish in the field.

Answer 14

Braxton-Hicks Contractions

Question 15

when true contractions occur (dilation and effacement begin) and ends with the complete dilation/effacement of the cervix.

Answer 15

Stage 1 of labor

Question 16

complete dilation of the cervix and ends when the fetus is delivered.

Answer 16

Stage 2 of labor

Question 17

Begins with the delivery of the fetus and ends with the delivery of the placenta.

Answer 17

Stage 3 of labor

Question 18

Average normal maternal blood loss with delivery

Answer 18

500 ml or 1 pint

Question 19

Dusky colored extremities with pink central color in a neonate. Common in the first hours of life.

Answer 19

Acrocyanosis

Question 20

Appearance. Pulse. Grimace. Activity. Respirations.

Answer 20

APGAR Score

Question 21

Other than normal signs of respiratory distress/arrest or hypoxia, when should respiration be given to a neonate?

Answer 21

If the heart rate falls below 100 BPM.

Question 22

Other than in cardiac arrest, when should chest compression be given to a neonate?

Answer 22

If the heart rate falls below 60 BPM with no response to ventilatory support.

Question 23

A condition in which the buttocks or both feet of the fetus present first in birth instead of the cranium.

Answer 23

Breech presentation

Question 24

When the umbilical cord presents during birth before the fetus.

Answer 24

Prolapsed cord

Question 25

Complications of a prolapsed cord

Answer 25

Compression of the cord can cause fetal distress due cessation of fetal circulation.

Question 26

A single arm or leg presents during birth before the cranium of the fetus.

Answer 26

Limb presentation

Question 27

Do not touch the limb. Do not attempt birth. Transport to closest capable facility. Assist mother into knee to chest position if possible.

Answer 27

Standard limb presentation guidelines

Question 28

During labor, the infant shoulders become stuck at the pubic symphysis. The head delivers normally and then sucks back into the vagina.

Answer 28

Shoulder dystocia

Question 29

The fetus passes feces into the amniotic fluid. This suggest the fetus had a hypoxic episode. There is a risk of aspiration of stain fluid, respiratory distress, and later pulmonary infection. Instead of a clear fluid/ light straw color, the amniotic fluid is light yellowish green to dark green.

Answer 29

Meconium staining

Question 30

The loss of more than 500 mL of blood by the mother immediately after birth.

Answer 30

Postpartum hemorrhage