Obstetrics 6 Flashcards
All the risk factors for placental abruption
increase the driving pressure to the placenta
Placental abruption is a
partial or complete separation of the placenta from the uterine wall before delivery
With placental abruption, ______ is possible if the fetus is stable
vaginal delivery
Anesthetic management for the placental abruption includes
obtain large-bore IV access
have blood products available
prepare for C-section
Placental abruption increases the risk of
amniotic fluid embolism leading to DIC
What is the MOST common cause of postpartum hemorrhage?
a. uterine atony
b. retained placenta
c. disseminated intravascular coagulopathy
d. uterine inversion
A. uterine atony
Risk factors for uterine atony include
multiparity
multiple gestations
polyhydramnios
prolonged oxytocin infusion before surgery
Etiologies of uterine bleeding include
retained placenta
laceration
uterine inversion
coagulopathy
placenta previa
placental abruption
abnormal placental implantation
Risk factors for maternal DIC include
amniotic fluid embolism, placental abruption, intrauterine fetal demise
Describe treatments for obstetric bleeding
uterine massage
oxytocin
ergot alkaloids
manual massage
intrauterine balloon
Describe what drugs are considered minimally cardiovascular depressive in the bleeding obstetric patient.
ketamine
etomidate
midazolam
opioids
In the hemodynamically unstable patient, it may be prudent to
convert a regional anesthetic to a general anesthetic with RSI
Five minutes following delivery, a newborn has an irregular respiratory rate with a heart rate of 105. He is grimacing, has some flexion in the extremities, and has a pink body with blue extremities. Calculate his Apgar score.
6
(1+2+1+1+1)
The Apgar score at 1 minute correlates with
fetal acid-base status
The Apgar score at 5 minutes may be predictive of
neurologic outcome