Trauma Flashcards
1
Q
Initial eval for OB trauma HPI
A
GA seat belt use air bag deploy abd pain VB FM resuscitation efforts direct abd trauma
2
Q
OB trauma eval PE
A
*May defer pelvic exam if no VB or CNZ US to assess: - FHT - placental location - GA - AFI
*do not use US to determine abruption
3
Q
OB trauma labs
A
CBC T&S PT, PTT, fibrinogen KB stain UDS
4
Q
if fetus has died of trauma…
A
- assume massive placental abruption
- anticipate massive coagulopathy
- be prepared with 6 units PRBCs and FFP
- Admit to L&D if >16-20 weeks per hosp
5
Q
OB trauma emergency C/S delivery when…
A
imminent maternal death
OR
stable patient with nonreassuring FHT pattern
6
Q
OB perimortem cesarean, why and how
A
bc pregnant uterus impedes the efforts of cardiopulmonary resuscitation, cesarean aids in maternal resuscitation
> 24w
w/in 4 minutes of maternal cardiac arrest
(unlikely fetal survival 15 m after maternal cardiac arrest)
midline from xyphoid to pubic symphysis, classical hysterotomy
7
Q
Plan for trauma on L&D
A
- continue coord. with trauma team
- H&P with pelvic exam
- US biometry and AFI
- 300 ug Rhogam IM if
1. RhD negative
2. >30 mL of feto-maternal bleeding on KB - FHT for > 4h
8
Q
abruption unlikely if (history key)
A
< 6 CNX per hour over 4 hours
