ITLS - International Trauma Life Support Trauma in Pregnancy Questions and Answers

Question 1

You are treating a 30-year-old female, 32 weeks pregnant, who was involved in a motor vehicle collision.
She is secured to a long backboard.
Her initial BP was 110/70 mmHg, but it has now dropped to 90/50 mmHg with an increased heart rate.
What is the most appropriate immediate intervention?

Accepted Answer

Manually displace the uterus to the left.

Answer

Administer a 1-liter normal saline bolus.

Answer

Prepare for immediate rapid transport.

Answer

Apply high-flow oxygen via a non-rebreather mask.

Question 2

Following blunt abdominal trauma in a pregnant patient, which of the following is the most common serious pregnancy-specific complication that can lead to fetal distress or demise?

Accepted Answer

Placental abruption

Answer

Uterine rupture

Answer

Premature rupture of membranes

Answer

Direct fetal injury

Question 3

Why can a pregnant patient in her third trimester lose a significant amount of blood before showing classic signs of shock, such as a significant drop in blood pressure?

Accepted Answer

Maternal blood volume increases by 40-50% during pregnancy.

Answer

Uterine compression of the femoral arteries maintains pressure.

Answer

Decreased maternal heart rate conserves circulatory volume.

Answer

Physiological anemia of pregnancy lowers oxygen demand.

Question 4

When managing a critically injured pregnant patient, what is the single most important principle for ensuring the well-being of the fetus?

Accepted Answer

Aggressively resuscitating and stabilizing the mother.

Answer

Determining fetal heart tones with a doppler.

Answer

Administering medications to prevent preterm labor.

Answer

Preparing for a potential emergency field delivery.

Question 5

A 28-year-old female who is 26 weeks pregnant has signs of hemorrhagic shock after a fall. How should fluid resuscitation for this patient differ from that for a non-pregnant patient?

Accepted Answer

Resuscitation should be more aggressive due to physiological hypervolemia.

Answer

Fluid resuscitation should be less aggressive to prevent pulmonary edema.

Answer

Crystalloid fluids are contraindicated; only blood products should be used.

Answer

The target systolic blood pressure should be lower (permissive hypotension).

Question 6

In the context of maternal trauma, which finding is the most critical indicator that fetal perfusion is likely compromised?

Accepted Answer

Maternal hypotension

Answer

Maternal tachycardia

Answer

Presence of uterine contractions

Answer

A fundal height smaller than expected for gestational age

You are treating a 30-year-old female, 32 weeks pregnant, who was involved in a motor vehicle collision.She is secured to a long backboard.Her initial BP was 110/70 mmHg, but it has now dropped to 90/50 mmHg with an increased heart rate.What is the most appropriate immediate intervention?

You are treating a 30-year-old female, 32 weeks pregnant, who was involved in a motor vehicle collision.
She is secured to a long backboard.
Her initial BP was 110/70 mmHg, but it has now dropped to 90/50 mmHg with an increased heart rate.
What is the most appropriate immediate intervention?