OB/GYN Emergencies Flashcards

A 34-year-old woman at 28 weeks gestation is involved in a motor vehicle collision. She complains of continuous abdominal pain and board-like rigidity. Fetal heart tones are 90 bpm. The EMT should suspect:

Answer: Abruptio placentae with fetal distress

Trauma-triggered abruptio placentae presents with painful, rigid uterus and fetal bradycardia; this is a life-threatening emergency requiring immediate transport.

To control postpartum hemorrhage in the field, fundal massage is performed. The CORRECT technique is:

Answer: Place one hand above the pubic symphysis and the other on the fundus, massage in a circular motion

Bimanual external uterine massage places one hand suprapubically to stabilize the lower uterine segment while the other massages the fundus to stimulate contraction.

A woman delivers a baby in the field at 24 weeks gestation. The neonate is 600 grams, limp, and apneic. Which of the following actions is MOST appropriate?

Answer: Begin resuscitation per NRP protocol and transport to the nearest NICU-capable facility

At 24 weeks gestation, survival is possible; EMTs should initiate NRP resuscitation and transport to a facility with neonatal intensive care capability, following local protocols.

During a breech delivery in the field, the baby's body delivers to the level of the umbilicus but the head is retained. The EMT should:

Answer: Support the body, allow the head to deliver by gravity, and create an airway with two fingers if needed

In a retained aftercoming head, the EMT supports the body weight, allows gravity to assist, and if needed, inserts two fingers along the baby's face to maintain an airway while awaiting delivery.

Which of the following findings would indicate a NORMAL newborn assessment at 5 minutes of life?

Answer: HR 120, acrocyanosis only, strong cry, active movement

A 5-minute APGAR of approximately 8–10 is normal: HR ≥100, peripheral cyanosis (acrocyanosis) only, vigorous cry, and active muscle tone are all reassuring signs.

A woman in her third trimester calls 911 for vaginal bleeding with painful contractions and a uterus that does not relax between contractions. Her BP is 80/50 and HR is 130. Management priority is:

Answer: IV fluid resuscitation, oxygen, and rapid transport in left lateral position

Hemorrhagic shock from severe abruptio placentae requires aggressive fluid resuscitation, high-flow oxygen, and immediate transport with left lateral tilt to prevent aortocaval compression.

Which drug, when used by the mother shortly before delivery, is MOST likely to cause neonatal respiratory depression requiring positive-pressure ventilation?

Answer: Opioid analgesics (e.g., fentanyl, morphine)

Opioids cross the placenta and cause neonatal central nervous system and respiratory depression; naloxone may be indicated per protocol if maternal opioid use is confirmed.