Obstetric Emergencies Flashcards
What is the definition of eclampsia?
The occurrence of tonic-clinic seizures with a diagnosed pre-eclampsia.
What are the possible causes of eclampsia?
Cerebral oedema and ischemia.
What is the risk of seizure occurrence in relation to delivery?
Risk of seizure greatest in first 24 hours; can occur before, during, or after delivery.
What is the initial management step for a seizure?
Call for help.
What is the treatment regimen for eclampsia?
MgSO4 4g loading + 1g/h IVI.
What is the primary cure for eclampsia?
Delivery of the placenta.
What characterizes HELLP syndrome?
Haemolysis, elevated LFTs, low platelets.
What are common symptoms of HELLP syndrome?
RUQ/epigastric pain, nausea, vomiting, tea-colored urine.
What are the complications associated with HELLP syndrome?
AKI, placental abruption, stillbirth.
What are the differential diagnoses for HELLP syndrome?
- Biliary colic * Cholecystitis * Hepatitis * GORD * Gastroenteritis * Pancreatitis * Ureteral calculi or pyelonephritis * ITP or TTP.
What is the management approach for HELLP syndrome?
As per severe pre-eclampsia: stabilize mum, evaluate fetus, determine delivery timing/route.
What is the definition of postpartum hemorrhage?
> 500 ml blood loss.
What are some antepartum risk factors for postpartum hemorrhage?
- Pre-eclampsia
- Nulliparity
- Multiple gestation
- Previous PPH
- Previous C-section.
What is one key prevention strategy for postpartum hemorrhage?
Actively manage the third stage of labor.
What are the two types of third stage management?
- Expectant * Active.
What is the most common cause of postpartum hemorrhage?
Tone (uterine atony).
What are the four main causes of postpartum hemorrhage known as the 4Ts?
- Tone (70%) * Trauma (20%) * Tissue (10%) * Thrombin (1%).
What is the first-line oxytocic agent for managing postpartum hemorrhage?
Oxytocin.
What are the side effects of prostaglandins used in postpartum hemorrhage?
- Nausea * Diarrhea * Flushing * Headache.
What is a key sign of uterine inversion?
Shock disproportionate to blood loss.
What are the signs of uterine rupture?
- Sudden change in FHR tracing * Vaginal bleeding * Abdominal tenderness * Maternal tachycardia.
What characterizes retained placenta?
Placenta not delivered within 30 minutes.
What is the management for coagulopathy in postpartum hemorrhage?
Treat underlying disorder, maintain fibrinogen, platelets, and hematocrit levels.
What is the first step in the OSCE PPH drill?
Call for senior help.
What are the signs and symptoms of sepsis in the postpartum period?
- Vaginal bleeding/pain * Fever * Nausea * Tachycardia * Tender uterus.
What is the definition of shoulder dystocia?
Delivery that requires additional obstetric manoeuvres to release the shoulder after gentle downward traction fails.
What are the antenatal risk factors for shoulder dystocia?
- Macrosomia * Previous big baby or shoulder dystocia * Maternal diabetes * Obesity.
What is the management acronym for shoulder dystocia?
HELPER.
What is cord prolapse?
When the umbilical cord descends alongside the presenting part before delivery.
What are the types of cord prolapse?
- Occult prolapse
- Cord presentation
- Cord (overt) prolapse.
What is the management aim for cord prolapse?
Preserve membranes and expedite delivery.
What can be a complication of cord prolapse?
Foetal anoxia and death.
