ABOG Risk Management & Mitigation 2

Question 1

A patient undergoing cesarean delivery develops uncontrolled hemorrhage from a placenta accreta spectrum. Which stepwise surgical intervention is most appropriate BEFORE proceeding to hysterectomy?

Accepted Answer

Uterine compression sutures and bilateral uterine artery ligation

Answer

Uterine compression sutures (e.g., B-Lynch) combined with uterine artery ligation represent recommended conservative surgical steps before hysterectomy in refractory postpartum hemorrhage.

Question 2

Which documentation practice best reduces medicolegal risk when a patient declines recommended fetal monitoring during labor?

Accepted Answer

Document the refusal, risks discussed, and patient's understanding in the medical record

Answer

Thorough documentation of informed refusal—including risks explained and patient's demonstrated understanding—creates a defensible medical record.

Question 3

A patient at 34 weeks gestation with suspected sepsis has a lactate of 4.2 mmol/L. What is the most critical immediate intervention per Surviving Sepsis guidelines?

Accepted Answer

IV fluid resuscitation with 30 mL/kg crystalloid and broad-spectrum IV antibiotics within 1 hour

Answer

Sepsis-3 bundle requires prompt IV fluid resuscitation and broad-spectrum antibiotics within 1 hour when lactate ≥2 mmol/L, signaling tissue hypoperfusion.

Question 4

Which action most effectively reduces wrong-site or wrong-patient surgical errors in obstetric and gynecologic procedures?

Accepted Answer

Completing a formal surgical time-out with all team members present before incision

Answer

The Universal Protocol requires a pre-incision time-out involving all team members to verify patient identity, procedure, and site, reducing never events.

Question 5

A postoperative hysterectomy patient develops fever, tachycardia, and purulent wound discharge on day 4. Which risk management step is most important after initiating treatment?

Accepted Answer

Notify the hospital risk management team and complete an incident report

Answer

Adverse events require timely incident reporting to risk management to facilitate investigation, quality improvement, and appropriate patient communication.

(ABOG) American Board of Obstetrics & Gynecology Practice Test

(ABOG) American Board of Obstetrics & Gynecology Practice Test

ABOG Risk Management & Mitigation 2