Obstetric and Gynecological Emergencies Flashcards

A 32-week pregnant patient presents with painless bright-red vaginal bleeding. Which condition should the flight paramedic suspect first?

Answer: Placenta previa

Placenta previa classically presents with painless bright-red vaginal bleeding in the second or third trimester.

During a flight transport, a laboring patient delivers the head but the shoulders become impacted. What is the FIRST maneuver to attempt?

Answer: McRoberts maneuver with suprapubic pressure

McRoberts maneuver (hyperflexion of maternal thighs) combined with suprapubic pressure is the first-line intervention for shoulder dystocia.

A patient at 36 weeks gestation presents with severe hypertension (180/110 mmHg), headache, and visual disturbances. Which medication is most appropriate for acute BP management in-flight?

Answer: Hydralazine or labetalol IV

IV hydralazine or labetalol are first-line agents for acute severe hypertension in preeclampsia, as they are safe in pregnancy and allow titrated control.

Which magnesium sulfate finding during eclampsia management should prompt the flight paramedic to stop the infusion immediately?

Answer: Loss of deep tendon reflexes

Loss of deep tendon reflexes is an early sign of magnesium toxicity and warrants stopping the infusion before respiratory arrest occurs.

A post-partum patient develops heavy vaginal bleeding unresponsive to fundal massage. What is the most common cause of postpartum hemorrhage?

Answer: Uterine atony

Uterine atony accounts for approximately 80% of postpartum hemorrhage cases and is the most common cause.

When transporting a patient with suspected placental abruption, which finding MOST suggests fetal compromise?

Answer: Fetal bradycardia below 100 bpm

Fetal bradycardia below 100 bpm is a direct indicator of fetal distress and signals compromised uteroplacental perfusion.