OB Hemorrhage

Question 1

How much does one unit of PRBC change the Hct and Hb?

Answer 1

Raises Hct by 3% and Hb by 1g/dL

Question 2

What is the most common cause of third trimester bleeding and how does it present?

Answer 2

Placental abruption

Painful bleeding, uterine tenderness

Question 3

What is the most common risk factor for placental abruption?

Answer 3

Maternal hypertension

Question 4

What is the blood loss required to be determined a postpartum hemorrhage?

Answer 4

> 500cc following a vaginal birth

>1000cc following a c section

Question 5

What is the difference between primary and secondary postpartum hemorrhage?

Answer 5

Primary- Within first 24 hours (usually uterine atony)

Secondary- 24hrs to 12 weeks

Question 6

What patients are Methylergonovine (Methergine) and 15-Methyl prostaglandin F2a (Hematite) contraindicated in?

Answer 6

Methylergonovine (IM)-C/I in HTN

15-Methyl prostaglandin F2a (IM)- C/I in asthmatics

Question 7

What des one unit (50cc) of platelets have as an effect?

Answer 7

Increase platelet count 5k-10k per unit

Question 8

What does one unit of FFP have an effect on?

Answer 8

Fibrinogen–> increases by 10mg/dL per unit

Question 9

What are the subtypes of septic pelvic thrombophlebitis and which type causes a clinically ill appearance?

Answer 9

Ovarian Vein Thrombophlebitis- clinically ill

Deep septic pelvic vein thrombophlebitis- not appear clinically ill

Question 10

What screening tool is a good predictive value that there will not be preterm labor if it is negative?

Answer 10

Fetal fibronectin

Question 11

What tests can be used to confirm PROM and what should you NOT do?

Answer 11

Can do pooling, nitrazine paper, and ferning

Do NOT check cervix of presumed rupture preterm pt (increased risk of infection)