Scary Emergencies
Following delivery of the fetal head, the shoulders fail to deliver despite gentle traction. This emergency requires immediate maneuvers such as McRoberts positioning.
What is Should Dystocia?
In the four Ts of postpartum hemorrhage, the most common etiology belongs in this category?
What is tone?
Fever, uterine tenderness, and foul-smelling lochia after cesarean delivery suggest this postpartum infection.
An elevated second-trimester maternal serum level of this fetal protein can prompt evaluation for an open neural tube defect. (entire name required)
What is alpha-fetoprotein?
For a patient receiving magnesium sulfate who develops absent deep tendon reflexes and respiratory depression, this IV medication is the antidote.
What is calcium gluconate?
A patient with a positive pregnancy test presents with sudden pelvic pain, syncope, hypotension, and free intraperitoneal fluid. This diagnosis requires urgent surgical evaluation.
What is ruptured ectopic pregnancy?
An antifibrinolytic medication which is a biochemical analog to this amino acid should be administered as soon as possible, within three hours of birth, for postpartum hemorrhage in addition to standard care.
What is lysine?
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Three days postpartum, a patient develops sudden severe abdominal pain, temperature of 39.5°C, tachycardia, and rapidly progressive hypotension. Blood cultures reveal gram-positive cocci in chains. This organism is associated with rapidly progressive puerperal sepsis and toxin-mediated shock.
The NT obtained between 11 and 13 weeks plus 6 days that helps assess fetal aneuploidy risk and may suggest structural abnormalities if the measurement exceeds this amount.
What is 3-3.5mm?
This commonly used oral tocolytic reduces myometrial contractility by blocking L-type calcium channels.
What is nifedipine?
After delivery, a patient has severe hemorrhage, an absent fundus on abdominal palpation, and a mass protruding through the cervix. This is the diagnosis requiring immediate uterine replacement.
What is uterine inversion.
During active severe postpartum hemorrhage, platelet transfusion is commonly targeted to maintain the platelet count above approximately this value per microliter.
What is 50,000?
A patient at 35 weeks presents with fever, a diffuse vesicular rash, progressive dyspnea, and bilateral pulmonary infiltrates. Oxygen saturation is 87% on room air. Which viral infection is most likely responsible for this potentially life-threatening maternal complication?
What is varicella zoster virus causing pneumonia?
Maternal obesity is associated with a higher probability that cfDNA screening will return a no-call result due to an insufficient proportion of placental DNA, known by this term.
What is low fetal cell fraction?
Prolonged administration of high-dose oxytocin with large volumes of hypotonic fluid may cause seizures through this electrolyte disturbance.
What is profound hyponatremia?
A 36-week patient develops nausea, jaundice, hypoglycemia, elevated bilirubin, and prolonged PT. This potentially fatal pregnancy-specific disorder must be distinguished from HELLP syndrome.
What is acute fatty liver of pregnancy?
A 29-year-old G2P1 develops significant vaginal bleeding 20 minutes after an uncomplicated vaginal delivery. The uterus is firm, and examination reveals no genital tract lacerations or retained placental tissue. Despite ongoing hemorrhage, her initial hemoglobin is 11.8 g/dL, only slightly below her admission value of 12.1 g/dL. This physiologic principle explains why her hemoglobin may remain nearly normal despite substantial acute blood loss.
What is delayed hemodilution (or delayed plasma volume equilibration)?
After eating unpasteurized cheese, a pregnant patient develops a febrile illness. Blood cultures grow a gram-positive rod associated with miscarriage and neonatal sepsis; this antibiotic is a preferred treatment.
What is ampicillin?
A child has Down syndrome, but the chromosome count is 46 because chromosome 21 material is attached to chromosome 14. This structural rearrangement is called this.
What is a Robertsonian translocation?
This NSAID used as a tocolytic earlier in pregnancy is generally avoided later in gestation because it may constrict the fetal ductus arteriosus and reduce amniotic fluid volume.
What is indomethacin?
Two days after cesarean delivery, a patient has rapidly worsening incisional pain out of proportion to examination, tachycardia, and evolving skin discoloration. This surgical emergency requires immediate debridement rather than waiting for definitive imaging.
What is necrotizing fasciitis?
Weeks after delivery, a patient develops extensive spontaneous bruising and a markedly prolonged aPTT that fails to correct on a mixing study, while PT and platelets are normal. This rare acquired bleeding disorder results from autoantibodies to factor VIII.
What is acquired hemophilia A?
A 38-year-old G2P2 with a copper IUD in place for 9 years presents with worsening pelvic pain, intermittent fevers, and weight loss. CT imaging reveals a complex pelvic mass with infiltrative changes extending across tissue planes, raising concern for an invasive malignancy. A biopsy instead demonstrates this branching, filamentous gram-positive organisms with sulfur granules.
What is Actinomyces israelii?
In Fragile X syndrome, an FMR1 premutation may expand into a full mutation in successive generations, particularly through maternal transmission. This inheritance phenomenon is known by this term.
What is genetic anticipation?
Following inadvertent intravascular injection of a local anesthetic during an OB/GYN procedure, a patient develops seizures and ventricular arrhythmias. In addition to resuscitation, this IV emulsion is a specific rescue treatment.
What is 20% lipid emulsion (intravenous lipid therapy)?