AEMT Obstetric and Gynecological Emergencies 1 — Questions and Answers
Question 1: During a normal delivery, once the baby's head is delivered, you should immediately:
- Clamp and cut the umbilical cord
- Check for a nuchal cord and suction the airway if needed (Correct answer)
- Administer oxytocin to the mother
- Deliver the placenta before suctioning
Correct answer: Check for a nuchal cord and suction the airway if needed
After head delivery, check for a nuchal cord (cord around the neck) and suction the mouth and nose to clear the airway before full delivery.
Question 2: A pregnant patient at 32 weeks gestation is found unresponsive after a syncopal episode. You should position her:
- Supine with legs elevated 12 inches
- Left lateral recumbent or with a wedge under her right hip to tilt the uterus left (Correct answer)
- Prone to protect the fetus
- Sitting upright at 90 degrees
Correct answer: Left lateral recumbent or with a wedge under her right hip to tilt the uterus left
Positioning the pregnant patient with left lateral tilt relieves aortocaval compression by the gravid uterus, improving venous return and cardiac output.
Question 3: Signs and symptoms of eclampsia include:
- Hypotension, bradycardia, and visual improvement
- Hypertension, proteinuria, severe headache, and seizures (Correct answer)
- Painless vaginal bleeding with normal blood pressure
- Fever, rigid abdomen, and septic shock
Correct answer: Hypertension, proteinuria, severe headache, and seizures
Eclampsia is characterized by hypertension, proteinuria, and the development of grand mal seizures in a pregnant or postpartum patient.
Question 4: A pregnant patient is in active labor and you can see the baby's foot in the vaginal opening. This is called:
- Placenta previa
- Abruptio placentae
- Breech presentation (Correct answer)
- Prolapsed cord
Correct answer: Breech presentation
A breech presentation occurs when the baby's buttocks or feet are the presenting part instead of the head.
Question 5: What is the MOST important initial action when a prolapsed umbilical cord is identified?
- Attempt to push the cord back into the uterus
- Position the mother in knee-chest or Trendelenburg and keep the cord moist and warm (Correct answer)
- Administer high-flow oxygen and transport without touching the cord
- Clamp the cord to prevent blood flow
Correct answer: Position the mother in knee-chest or Trendelenburg and keep the cord moist and warm
Elevating the presenting part off the cord (knee-chest or Trendelenburg position) relieves cord compression while keeping the cord moist and warm prevents spasm.
Question 6: The Apgar score is assessed at which time intervals after birth?
- Immediately at birth and at 5 minutes
- 1 minute and 5 minutes after birth (Correct answer)
- 2 minutes and 10 minutes after birth
- At delivery and at 15 minutes
Correct answer: 1 minute and 5 minutes after birth
The Apgar score is formally assessed at 1 minute and 5 minutes after birth to evaluate the neonate's physiological status.
AEMT Obstetric and Gynecological Emergencies 1
During a normal delivery, once the baby's head is delivered, you should immediately: