AEMT Obstetric and Gynecological Emergencies 2 — Questions and Answers
Question 1: Which of the following correctly describes placenta previa?
- The placenta prematurely separates from the uterine wall, causing painful bleeding
- The placenta implants over or near the cervical os, causing painless bright-red vaginal bleeding (Correct answer)
- The umbilical cord prolapses through the cervix before the baby
- The uterus ruptures along a previous scar
Correct answer: The placenta implants over or near the cervical os, causing painless bright-red vaginal bleeding
Placenta previa involves abnormal low implantation of the placenta over the cervical opening, producing painless bright red third-trimester bleeding.
Question 2: Abruptio placentae is characterized by:
- Painless vaginal bleeding in the third trimester
- Painful dark vaginal bleeding with a rigid, board-like uterus (Correct answer)
- Fetal foot presenting at the vaginal opening
- Severe vomiting in the first trimester
Correct answer: Painful dark vaginal bleeding with a rigid, board-like uterus
Abruptio placentae causes painful, dark vaginal bleeding with uterine rigidity because the placenta separates from the uterine wall, trapping blood.
Question 3: In a field delivery, the umbilical cord should be clamped and cut:
- Immediately at birth before stimulation
- Once the baby is breathing and crying; clamp at 2–3 cm and 5 cm from the navel (Correct answer)
- After the placenta delivers
- Only if the baby is cyanotic
Correct answer: Once the baby is breathing and crying; clamp at 2–3 cm and 5 cm from the navel
After confirming the neonate is stable and breathing, clamp the cord at two points (2–3 cm and 5 cm from the navel) and cut between the clamps.
Question 4: A newborn is delivered and remains blue, limp, and apneic after 30 seconds of stimulation and warming. The NEXT step is:
- Begin chest compressions immediately
- Ventilate with a neonatal BVM at 40–60 breaths/min with 21% oxygen (Correct answer)
- Administer epinephrine IM
- Clamp and cut the cord and defer to the hospital
Correct answer: Ventilate with a neonatal BVM at 40–60 breaths/min with 21% oxygen
For an apneic newborn who does not respond to initial stimulation, positive pressure ventilation at 40–60 breaths/min with room air (21% O2) is the priority intervention.
Question 5: Postpartum hemorrhage is defined as blood loss exceeding how much after vaginal delivery?
- 250 mL
- 500 mL (Correct answer)
- 1,000 mL
- 1,500 mL
Correct answer: 500 mL
Postpartum hemorrhage is traditionally defined as blood loss greater than 500 mL following a vaginal delivery.
Question 6: The MOST common cause of postpartum hemorrhage is:
- Retained placental fragments
- Uterine atony (failure of the uterus to contract) (Correct answer)
- Cervical laceration
- Coagulation disorder
Correct answer: Uterine atony (failure of the uterus to contract)
Uterine atony, the failure of the uterus to contract after delivery, accounts for approximately 80% of postpartum hemorrhage cases.
AEMT Obstetric and Gynecological Emergencies 2
Which of the following correctly describes placenta previa?