CMS Obstetric Complications & Emergency Management Flashcards

HELLP syndrome is characterized by which laboratory findings?

Answer: Hemolysis, elevated liver enzymes, low platelets

HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets, a severe variant of preeclampsia with significant maternal morbidity.

Which intervention is first-line for primary postpartum hemorrhage (PPH) from uterine atony?

Answer: Uterine massage and IV oxytocin

Uterine massage combined with IV oxytocin is the first-line treatment for atonic PPH, promoting uterine contraction and vasoconstriction.

A laboring patient at 39 weeks suddenly becomes hypotensive, cyanotic, and develops coagulopathy minutes after AROM. What is the most likely diagnosis?

Answer: Amniotic fluid embolism (AFE)

AFE presents with sudden cardiovascular collapse, respiratory failure, and DIC following rupture of membranes or delivery, and carries high maternal mortality.

Which antihypertensive is the first-line agent for acute severe hypertension in pregnancy in the US?

Answer: Labetalol IV or hydralazine IV

IV labetalol and IV hydralazine are both first-line agents for acute severe hypertension in pregnancy; ACE inhibitors like enalapril are contraindicated.

The recommended management for a patient with shoulder dystocia that does not resolve with McRoberts maneuver and suprapubic pressure is:

Answer: Rubin II or Woods screw maneuver to rotate the fetal shoulder

If McRoberts and suprapubic pressure fail, rotational maneuvers (Rubin II, Woods screw, Zavanelli) are performed; fundal pressure worsens impaction.

Which fetal heart rate pattern requires immediate delivery or intrauterine resuscitation measures?

Answer: Sinusoidal pattern with absent variability

A sinusoidal FHR pattern with absent variability is a Category III (ominous) pattern indicating severe fetal compromise requiring immediate intervention.