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Obstetrics > Obstetric Emergencies > Flashcards

Obstetric Emergencies Flashcards

1
Q

What is the risk of uterine rupture with a previous LTCS?

A

0.5 - 0.9%

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2
Q

What is the risk of uterine rupture with a previous classical cesarean section?

A

4-9%

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3
Q

What is the risk of uterine rupture with a previous T shaped incision?

A

1 - 7%

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4
Q

In a shoulder dystocia what is the rate of pH decrease per minute?

A

0.04 unit/min

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5
Q

In a shoulder dystocia, how long does it take for the pH to go from 7.2 –> 7.0

A

5 minutes

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6
Q

What percent of shoulder dystocias are resolved with the McRoberts maneuver alone?

A

42%

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7
Q

What is the definition of the woodscrew maneuver?

A

anterior pressure applied to the posterior shoulder, abducts the shoulder

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8
Q

What is the definition of the Rubin maneuver?

A

posterior pressure applied to the anterior shoulder, adducts the shoulder

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9
Q

What is the Zavanelli maneuver?

A

replacement of the fetal head into the uterus, delivery by cesarean section

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10
Q

What maneuver has the highest rate of success compared to other maneuvers during shoulder dystocia?

A

Delivery of the posterior arm, 85% successful

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11
Q

What are the initial maneuvers that should be attempted during a shoulder dystocia?

A

McRoberts, Suprapubic pressure

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12
Q

What is the average blood loss at time of SVD?

A

500

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13
Q

What is the average blood loss at the time of CS delivery?

A

1000

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14
Q

What is the average blood loss at the time of planned cesarean hysterectomy (Accreta)?

A

1400

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15
Q

What is the average blood loss at the time of emergent cesarean hysterectomy?

A

3000 - 3500

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16
Q

What is the most common cause of PPH?

A

Uterine atony 70 - 80%

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17
Q

What is the dose and timing that you can give Methergine during a PPH?

A

0.2 mg IM q 2-4 hrs

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18
Q

What is the dose and timing that you can give hemabate during a PPH?

A

0.25mg IM q 15 minutes

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19
Q

What is the dose and timing that you can give Misoprostal during a PPH?

A

600 - 1000mcg PO, PR, SL

20
Q

What is the incidence of Accreta with history of 0 prior CS delivery and known placenta previa?

A

3%

21
Q

What is the incidence of Accreta with 1 prior CS delivery and known placenta previa?

A

11%

22
Q

What is the incidence of Accreta with history of 2 prior CS delivery and known placenta previa?

A

40%

23
Q

What is the incidence of Accreta with history of 3 prior CS delivery and known placenta previa?

A

61&

24
Q

What is the incidence of Accreta with history of >4 prior CS delivery and known placenta previa?

A

67%

25
Q

What is the incidence of Accreta with history of >5 prior CS delivery and no known placenta previa?

A

4.7%

26
Q

TXA is what type of medicine?

A

Antofibrinolytic

27
Q

How do you dose TXA?

A

1g IV infusion over 10 minutes

28
Q

What risk does TXA reduce?

A

reduces PPH related death by 20 - 30% when given within 3 hrs of delivery

29
Q

In setting of hemorrhage, in what ratio should you give crystalloid to blood loss?

A

3:1 ratio to EBL

30
Q

What is the typical volume of 1 U PRBCs

A

300 cc

31
Q

1 unit PRBC increases the hgb by ____ and the HCT by ____.

A

1, 3 %

32
Q

What is the typical volume of 1 Unit of platelets

A

50 cc

33
Q

What is the typical volume of a 6 pack of platelets

A

300 cc

34
Q

1 unit increases the plt count by ____

A

75K

35
Q

a 6 pack of plts increases the plt count by

A

45K

36
Q

What are the indications to transfuse plts following vaginal delivery?

A

plts < 20 or DIC

37
Q

What are the indications to transfuse plts following a CS?

A

plts < 50 or DIC

38
Q

What is the typical volume of 1 U FFP?

A

250 cc

39
Q

What are the components of FFP?

A

Fibrinogen, antithrombin, factors V, XI, XII

40
Q

1 unit of FFP increases the fibroinogen level by _____

A

5-10mg/dL

41
Q

What are the indications to give FFP?

A

DIC (Fibrinogen < 200), Coagulopathic liver disease, wafarin reversal

42
Q

What is the typical volume of 1 unit of Cryoprecipitate?

A

40 cc

43
Q

What are the components of cryoprecipitate?

A

Fibrinogen, vWF, factor VIII, XIII

44
Q

What is the current recommended ratio of PRBC:plt: FFP during a massive transfusion?

A

1:1:1

45
Q

What is the mortality rate associated with maternal amniotic fluid embolism?

A

80%

46
Q

What is the pathophysiology of an amniotic fluid embolism?

A

Anaphylactic reaction to fetal cells/amniotic fluid that enter maternal circulation

Obstetrics (28 decks)

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