CMS Obstetric Complications & Emergency Management Flashcards

A patient at 32 weeks presents with painless, bright-red vaginal bleeding. Which condition is most likely?

Answer: Placenta previa

Placenta previa classically presents with painless, bright-red vaginal bleeding in the second or third trimester due to the placenta overlying the cervical os.

Which triad of findings is characteristic of severe preeclampsia requiring immediate intervention?

Answer: BP ≥160/110 mmHg, severe headache, visual disturbances

Severe-range preeclampsia features BP ≥160/110 plus severe symptoms such as severe headache, visual changes, or epigastric pain, mandating magnesium sulfate and delivery planning.

A patient experiences sudden, severe 'tearing' abdominal pain with fetal heart rate decelerations at 38 weeks. She has a prior uterine scar. The most likely diagnosis is:

Answer: Uterine rupture

Uterine rupture presents with sudden severe abdominal pain, loss of fetal station, and fetal distress, and is a life-threatening emergency requiring immediate cesarean.

Magnesium sulfate is administered in severe preeclampsia primarily to:

Answer: Prevent eclamptic seizures

Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia; antihypertensives are used separately for blood pressure control.

Which clinical finding most reliably distinguishes placental abruption from placenta previa?

Answer: Painful uterine contractions with dark vaginal bleeding

Placental abruption typically presents with painful, board-like uterine rigidity and dark vaginal bleeding, in contrast to the painless bleeding of placenta previa.

A patient in active labor has a sudden variable deceleration with cord palpable in the vagina. The priority nursing action is:

Answer: Elevate the presenting part off the cord and call for emergency cesarean

Cord prolapse requires immediate manual elevation of the presenting part to relieve compression while emergency cesarean is prepared.