Obstetric and Gynecologic Emergencies Flashcards

A pregnant woman at 32 weeks presents with sudden severe abdominal pain, a rigid abdomen, and fetal bradycardia. Vaginal bleeding is minimal. What is the most likely diagnosis?

Answer: Placental abruption

Placental abruption classically presents with sudden severe abdominal pain, uterine rigidity, and fetal distress; the bleeding may be concealed (minimal external bleeding).

When should cardiopulmonary resuscitation in a pregnant patient include lateral uterine displacement?

Answer: After 20 weeks gestation or when the uterus is palpable at the umbilicus

After 20 weeks gestation, the gravid uterus can compress the aorta and inferior vena cava; manual left lateral uterine displacement during CPR improves venous return.

A patient presents with sudden severe lower abdominal pain, fever, cervical motion tenderness, and mucopurulent cervical discharge. What is the most likely diagnosis?

Answer: Pelvic inflammatory disease (PID)

The classic triad of PID is lower abdominal pain, cervical motion tenderness, and adnexal tenderness, often accompanied by fever and cervical discharge.

What is the emergency treatment for ovarian torsion?

Answer: Emergent surgical detorsion

Ovarian torsion requires emergent surgical detorsion to restore blood flow and preserve ovarian viability; delay leads to ischemia and ovarian loss.

Magnesium toxicity in a preeclamptic patient on magnesium sulfate infusion is first evidenced by loss of which reflex?

Answer: Patellar (knee-jerk) reflex

Loss of the patellar reflex (deep tendon reflex) is the earliest clinical sign of magnesium toxicity, occurring at serum levels of 7–10 mEq/L before respiratory depression.

What is the antidote for magnesium sulfate toxicity causing respiratory depression in a preeclamptic patient?

Answer: Calcium gluconate 1 g IV

Calcium gluconate 1 g IV (10 mL of 10% solution) directly antagonizes the neuromuscular effects of magnesium and is the antidote for respiratory depression.