Obstetric and Gynecological Emergencies Flashcards

Which Apgar component assesses the newborn's muscle tone?

Answer: Activity (muscle tone)

The 'A' in Apgar stands for Activity, which evaluates the newborn's muscle tone as absent (0), some flexion (1), or active motion (2).

A pregnant patient at 36 weeks has a seizure. After controlling the airway, the MOST appropriate prehospital medication per protocol is:

Answer: Magnesium sulfate 4 g IV slow push per protocol

Magnesium sulfate is the drug of choice for eclamptic seizures in pregnancy, both for acute treatment and prevention of recurrence.

Which finding in a pregnant trauma patient is MOST concerning for significant internal hemorrhage?

Answer: Tachycardia exceeding 100 bpm with hypotension

Tachycardia with hypotension in a pregnant trauma patient signals significant hemorrhage; compensatory mechanisms can mask shock until 30–40% of blood volume is lost.

Shoulder dystocia occurs when:

Answer: The baby's anterior shoulder is impacted behind the maternal pubic symphysis after head delivery

Shoulder dystocia is an obstetric emergency where the baby's anterior shoulder becomes caught behind the pubic symphysis after the head has been delivered.

To assist with shoulder dystocia in the field, the McRoberts maneuver involves:

Answer: Hyperflexing the mother's thighs onto her abdomen to flatten the lumbar lordosis and widen the pelvis

The McRoberts maneuver hyperflexes the mother's thighs to her abdomen, straightening the lumbosacral curve and effectively widening the pelvic inlet to free the impacted shoulder.

A neonate has an Apgar score of 4 at one minute. The MOST appropriate action is:

Answer: Begin positive pressure ventilation (PPV) and stimulation

An Apgar score of 4–6 indicates a depressed neonate requiring assisted ventilation and continued stimulation to improve oxygenation.