ITLS In Pregnancy 3

Question 1

A 28-week pregnant trauma patient presents with uterine rigidity and severe abdominal pain after a fall. The fetal heart rate is 90 bpm. What is the priority intervention?

Accepted Answer

Immediate rapid transport to a trauma center

Answer

Fetal bradycardia with uterine rigidity suggests placental abruption requiring immediate surgical intervention only available at a hospital.

Question 2

Which physiologic change of pregnancy increases the risk of aspiration during airway management?

Accepted Answer

Reduced lower esophageal sphincter tone

Answer

Progesterone reduces lower esophageal sphincter tone and slows gastric emptying, increasing aspiration risk in pregnant patients.

Question 3

What is the minimum gestational age at which fetal viability is generally considered possible in the US?

Accepted Answer

22–24 weeks

Answer

Fetal viability is generally considered possible at 22–24 weeks of gestation with advanced neonatal support.

Question 4

When placing IV access in a critically injured pregnant patient, which site is preferred?

Accepted Answer

Antecubital fossa or above

Answer

IV access should be established above the diaphragm because the gravid uterus may compress the inferior vena cava, reducing flow from lower extremity IVs.

Question 5

Perimortem cesarean delivery (PMCD) should ideally be performed within how many minutes of maternal cardiac arrest for the best neonatal outcome?

Accepted Answer

5 minutes

Answer

PMCD performed within 5 minutes of maternal arrest gives the best chance of intact neonatal survival and may also improve maternal resuscitation.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS In Pregnancy 3