Obstetric Emergencies

Question 1

amniotic embolism clinical features

Answer 1

Acute presentation +
hypoxia
hypotension
siezures
shock
confusion
collapse
DIC
fetal distress

Question 2

amniotic embolism risk factors

Answer 2

disorders of uterus, amniotic fluid or placenta (placental abruption / praevia, polyhydraminos)
eclampsia
instrument delivery / C section
induction of labour
multiple pregnancy
increased maternal age
cervical laceration

Question 3

amniotic embolism management

Answer 3

ABCDE approach
resuscitation, high flow oxygen
in case of DIC, involve haematology

Question 4

amniotic embolism investigations

Answer 4

bloods (FBC, U+Es, clotting, ABG)
ECG (ischaemic changes)
Chest X-Ray (pulmonary oedema)

Question 5

Eclampsia definition

Answer 5

one or more siezures in a pre-eclamptic woman and absence of other neurological or metabolic causes

Question 6

eclampsia risk factors

Answer 6

chronic HTN
HTN
DM
pre-eclampsia or eclampsia in previous pregnancy
autoimmune disease (SLE, APS)

Question 7

eclampsia clinical features

Answer 7

new onset tonic-clonic seizure
end organ failure: headache, hyperreflexia, n/v, generalised oedema, RUQ pain +/- jaundice, visual disturbances, change in mental state

Question 8

pre-eclampsia triad

Answer 8

hypertension
proteinuria
oedema

Question 9

eclampsia investigations

Answer 9

FBC (v Hb, v platelets)
U+Es (^ urea, ^ creatinine, ^ urate, v urine output)
LFT (^ ALT, ^ AST, ^ bilirubin)
clotting studies (complication = DIC + HELLP syndrome)
abdo USS
neurological work up