PCP Obstetric and Gynecological Emergencies 1 — Questions and Answers
Question 1: During a normal delivery, which fetal part presents first?
- Buttocks
- Feet
- Head (vertex presentation) (Correct answer)
- Shoulder
Correct answer: Head (vertex presentation)
The vertex (head) presentation is normal, occurring in approximately 96% of deliveries.
Question 2: After delivery of the baby's head, the paramedic should immediately:
- Clamp and cut the umbilical cord
- Check for a nuchal cord and suction if needed (Correct answer)
- Deliver the placenta
- Administer oxytocin
Correct answer: Check for a nuchal cord and suction if needed
After the head delivers, check for a nuchal cord (cord around the neck) and suction the mouth and nose if secretions are present.
Question 3: Pre-eclampsia is defined as hypertension after 20 weeks gestation with:
- Hypoglycemia
- Proteinuria and/or organ dysfunction (Correct answer)
- Fever above 38°C
- Vaginal bleeding
Correct answer: Proteinuria and/or organ dysfunction
Pre-eclampsia is BP ≥140/90 mmHg after 20 weeks gestation, accompanied by proteinuria or signs of end-organ damage.
Question 4: Eclampsia differs from severe pre-eclampsia by the addition of:
- Higher blood pressure readings
- Grand mal seizures (Correct answer)
- Peripheral edema
- Visual disturbances
Correct answer: Grand mal seizures
Eclampsia is pre-eclampsia with the addition of tonic-clonic (grand mal) seizures.
Question 5: A pregnant patient at 32 weeks is experiencing vaginal bleeding that is painless. This presentation is most consistent with:
- Placental abruption
- Placenta previa (Correct answer)
- Ectopic pregnancy
- Uterine rupture
Correct answer: Placenta previa
Painless vaginal bleeding in the third trimester is characteristic of placenta previa, where the placenta covers the cervical os.
Question 6: The Apgar score is assessed at 1 and 5 minutes after birth. Which five criteria are evaluated?
- Activity, Pulse, Grimace, Appearance, Respiration (Correct answer)
- Alertness, Pulse, Grimace, Amplitude, Respiration
- Activity, Pressure, Grunting, Appearance, Reflex
- Alertness, Perfusion, Grimace, Appearance, Rate
Correct answer: Activity, Pulse, Grimace, Appearance, Respiration
APGAR: Activity (muscle tone), Pulse, Grimace (reflex irritability), Appearance (color), Respiration — scored 0–2 each.
PCP Obstetric and Gynecological Emergencies 1
During a normal delivery, which fetal part presents first?