ABOG Risk Management & Mitigation 5

Question 1

A patient with a history of two prior cesareans is found to have placenta previa on second-trimester ultrasound. What is the most important risk mitigation step for delivery planning?

Accepted Answer

Schedule delivery at a facility with interventional radiology, blood banking, and neonatal ICU capabilities, and counsel about placenta accreta spectrum risk

Answer

Patients with prior uterine surgery and placenta previa have elevated placenta accreta spectrum risk and should deliver at centers with multidisciplinary hemorrhage management capabilities.

Question 2

Which handoff communication tool is most widely recommended to reduce errors during transitions of care on labor and delivery?

Accepted Answer

Structured SBAR (Situation, Background, Assessment, Recommendation) handoff with read-back confirmation

Answer

SBAR structured handoff with read-back is endorsed by The Joint Commission and ACOG to standardize communication and reduce errors at transitions of care.

Question 3

A gynecologic oncology patient on chemotherapy presents with fever of 38.5°C and an ANC of 400 cells/µL. What is the most critical immediate intervention?

Accepted Answer

Hospital admission, blood cultures, and broad-spectrum IV antibiotics within 1 hour (febrile neutropenia protocol)

Answer

Febrile neutropenia is a medical emergency requiring immediate blood cultures and empiric broad-spectrum IV antibiotics within 1 hour to reduce mortality.

Question 4

After performing an unintended cystotomy during laparoscopic hysterectomy that was immediately repaired, what is the surgeon's most important risk management obligation?

Accepted Answer

Disclose the intraoperative complication to the patient, document thoroughly, and arrange urology follow-up

Answer

Full disclosure of intraoperative complications, even repaired ones, is ethically mandatory and reduces medicolegal risk; accurate operative documentation is essential.

Question 5

Which intervention most reduces the risk of maternal mortality from obstetric hemorrhage at a community hospital?

Accepted Answer

Implementing a standardized massive transfusion protocol with a predefined ratio of packed RBCs, FFP, and platelets

Answer

Massive transfusion protocols using balanced ratios (typically 1:1:1 of pRBC:FFP:platelets) reduce coagulopathy and mortality in obstetric hemorrhage.

(ABOG) American Board of Obstetrics & Gynecology Practice Test

(ABOG) American Board of Obstetrics & Gynecology Practice Test

ABOG Risk Management & Mitigation 5