Inpatient Obstetrical Certification NCC
Leading cause of perinatal admissions to the ICU Correct Answer: Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages Correct Answer: 17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to
Correct Answer: Placental abruption
Race most likely to die from post-partum hemorrhage Correct Answer: African Americans
Mortality rate (2006) for white women, African American women and Hispanic women in the
US, stated as deaths per 100,000 live births Correct Answer: White women 13.3/100,000
African American women 32.7/100,000
Hispanic women 10.2
68% of post-partum hemorrhage deaths occur within _______hours of delivery Correct Answer:
48
Obstetric hemorrhage is defined as a TBL or more than Correct Answer: 1000cc
The classic sign of placenta previa is Correct Answer: painless vaginal bleeding in the second
or third trimester of pregnancy
If you see painless vaginal bleeding in the second or third trimester of pregnancy, suspect
Correct Answer: Placenta previa
Risk factors for placenta previa Correct Answer: previous placenta previa, advanced maternal
age greater than 40, previous cesarean, short interval between pregnancies, multiparity,previous
abortions with curettage, smoking, race (Asian women at greatest risk), large placenta
In patients with suspected placenta previa, which comes first, a speculum examination or a
confirmatory ultrasound? Correct Answer: Do the ultrasound first
Fetal blood volume is Correct Answer: 100ml/kg
Changes noted during significant blood loss Correct Answer: Rising pulse rate
Increase in respiratory rate
Skin changes to pallor
Falling blood pressure (a late finding)
Decreased urinary output
Decreased LOC
, Characteristic findings in FHR if mother has a significant blood loss Correct Answer: Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and academia
Persistent late decelerations
Percentage of accreta among women with previa Correct Answer: 5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is Correct Answer:
Greater than 50%
Vasa previa Correct Answer: Fetal vessels cross the placental membranes in the lower uterine
segment and cover the cervical os
Velamentous cord insertion Correct Answer: Fetal vessels run across chorion and amnion
without protective Wharton's jelly before entering the placental surface
Succenturiate placenta Correct Answer: One or more small accessory lobes of placental
vascular tissue in membranes that are attached to main placenta by fetal vessels
Hemolysis Correct Answer: lysis of erythrocytes with the release of hemoglobin
HELLP Correct Answer: Hemolysis, Elevated Liver Enzymes, Low Platelets
Per AWHONN, patients with placenta previa should not be discharged to home until they have
gone_____hours with not bleeding Correct Answer: 72 hours
Classic symptom of placental abruption Correct Answer: Painful vaginal bleeding after 20
weeks gestation
Risk factors for placental abruption Correct Answer: Smoking increases risk 90%
Maternal hypertension 500% increased risk
Multiparity
Abortions
Illicit drug use
Short umbilical cord
Abdominal trauma
Rupture of membranes(due to sudden uterine decompression)
Leiomyoma behind placenta
ACOG standard for fetal monitoring for maternal abdominal trauma Correct Answer: Minimum
of 2-6 hours
DIC stands for Correct Answer: disseminated intravascular coagulation
Leading cause of perinatal admissions to the ICU Correct Answer: Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages Correct Answer: 17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to
Correct Answer: Placental abruption
Race most likely to die from post-partum hemorrhage Correct Answer: African Americans
Mortality rate (2006) for white women, African American women and Hispanic women in the
US, stated as deaths per 100,000 live births Correct Answer: White women 13.3/100,000
African American women 32.7/100,000
Hispanic women 10.2
68% of post-partum hemorrhage deaths occur within _______hours of delivery Correct Answer:
48
Obstetric hemorrhage is defined as a TBL or more than Correct Answer: 1000cc
The classic sign of placenta previa is Correct Answer: painless vaginal bleeding in the second
or third trimester of pregnancy
If you see painless vaginal bleeding in the second or third trimester of pregnancy, suspect
Correct Answer: Placenta previa
Risk factors for placenta previa Correct Answer: previous placenta previa, advanced maternal
age greater than 40, previous cesarean, short interval between pregnancies, multiparity,previous
abortions with curettage, smoking, race (Asian women at greatest risk), large placenta
In patients with suspected placenta previa, which comes first, a speculum examination or a
confirmatory ultrasound? Correct Answer: Do the ultrasound first
Fetal blood volume is Correct Answer: 100ml/kg
Changes noted during significant blood loss Correct Answer: Rising pulse rate
Increase in respiratory rate
Skin changes to pallor
Falling blood pressure (a late finding)
Decreased urinary output
Decreased LOC
, Characteristic findings in FHR if mother has a significant blood loss Correct Answer: Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and academia
Persistent late decelerations
Percentage of accreta among women with previa Correct Answer: 5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is Correct Answer:
Greater than 50%
Vasa previa Correct Answer: Fetal vessels cross the placental membranes in the lower uterine
segment and cover the cervical os
Velamentous cord insertion Correct Answer: Fetal vessels run across chorion and amnion
without protective Wharton's jelly before entering the placental surface
Succenturiate placenta Correct Answer: One or more small accessory lobes of placental
vascular tissue in membranes that are attached to main placenta by fetal vessels
Hemolysis Correct Answer: lysis of erythrocytes with the release of hemoglobin
HELLP Correct Answer: Hemolysis, Elevated Liver Enzymes, Low Platelets
Per AWHONN, patients with placenta previa should not be discharged to home until they have
gone_____hours with not bleeding Correct Answer: 72 hours
Classic symptom of placental abruption Correct Answer: Painful vaginal bleeding after 20
weeks gestation
Risk factors for placental abruption Correct Answer: Smoking increases risk 90%
Maternal hypertension 500% increased risk
Multiparity
Abortions
Illicit drug use
Short umbilical cord
Abdominal trauma
Rupture of membranes(due to sudden uterine decompression)
Leiomyoma behind placenta
ACOG standard for fetal monitoring for maternal abdominal trauma Correct Answer: Minimum
of 2-6 hours
DIC stands for Correct Answer: disseminated intravascular coagulation
