FP-C Obstetric and Gynecological Emergencies 2 — Questions and Answers
Question 1: A pregnant patient at 20 weeks is found supine and unconscious. What positional intervention should be performed immediately?
- Left lateral tilt or manual uterine displacement (Correct answer)
- Right lateral tilt
- Trendelenburg position
- Semi-Fowler's position
Correct answer: Left lateral tilt or manual uterine displacement
Left lateral tilt or manual left uterine displacement relieves aortocaval compression by the gravid uterus, improving cardiac output.
Question 2: A flight paramedic is managing a 28-week pregnant patient in cardiac arrest. How long should standard ACLS be attempted before performing perimortem cesarean delivery?
- 4 minutes (Correct answer)
- 10 minutes
- 15 minutes
- 20 minutes
Correct answer: 4 minutes
Perimortem cesarean delivery should be performed at 4 minutes of resuscitation, targeting delivery by 5 minutes to improve maternal and fetal outcomes.
Question 3: Which sign differentiates placental abruption from placenta previa on physical assessment?
- Painful uterine rigidity (Correct answer)
- Painless bright-red bleeding
- Soft non-tender uterus
- Presentation abnormality on palpation
Correct answer: Painful uterine rigidity
Placental abruption typically presents with painful, rigid ('board-like') uterus, contrasting with the painless bleeding of placenta previa.
Question 4: During neonatal resuscitation of a newborn delivered in-flight, if heart rate remains below 60 bpm after 30 seconds of positive pressure ventilation, what is the next intervention?
- Begin chest compressions at 3:1 ratio with ventilation (Correct answer)
- Intubate immediately
- Administer epinephrine
- Increase oxygen flow
Correct answer: Begin chest compressions at 3:1 ratio with ventilation
If HR remains <60 bpm after adequate positive pressure ventilation, chest compressions should be initiated at a 3:1 compression-to-ventilation ratio.
Question 5: A 24-year-old female presents with unilateral lower abdominal pain, vaginal spotting, and a positive pregnancy test. Her BP is 80/50 and HR 130. What is the priority intervention?
- Large-bore IV access, fluid resuscitation, and emergent transport (Correct answer)
- Pelvic exam to confirm diagnosis
- Administer methotrexate
- Obtain ultrasound before treatment
Correct answer: Large-bore IV access, fluid resuscitation, and emergent transport
Ruptured ectopic pregnancy causes life-threatening hemorrhage; immediate IV access, volume resuscitation, and rapid transport to surgical care are the priority.
Question 6: What is the initial drug of choice for eclamptic seizures in the prehospital setting?
- Magnesium sulfate 4-6 g IV over 15-20 minutes (Correct answer)
- Diazepam 10 mg IV push
- Phenytoin 1 g IV
- Lorazepam 4 mg IV
Correct answer: Magnesium sulfate 4-6 g IV over 15-20 minutes
Magnesium sulfate is the definitive treatment for eclamptic seizures, with a loading dose of 4-6 g IV over 15-20 minutes followed by maintenance infusion.
FP-C Obstetric and Gynecological Emergencies 2
A pregnant patient at 20 weeks is found supine and unconscious.
What positional intervention should be performed immediately?