A laboring patient at 38 weeks has a history of class III obesity, chronic hypertension, and pregestational diabetes. Which finding from her medical history is MOST important for stratifying her risk of an obstetric emergency on admission?
Assessment And Prevention
Question · Medium
Which set of vital sign trends in a postpartum patient should trigger activation of a Maternal Early Warning System (MEWS)?
Question · Easy
Protocol developed in 2014 by a national safety partnership that flags changes in pregnant and postpartum patients' vital signs and prompts escalation.
Obstetric deterioration
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Chapter 1: Maternal Assessment, Risk Stratification & Early Warning Systems
1.1 Pre-Existing Medical, Surgical & Obstetric Comorbidities in Emergency Risk Stratification
Study guide
Which physiologic change of pregnancy MOST commonly masks early hemorrhagic shock until 1500-2000 mL of blood loss has occurred?
Read the clue and guess the term in 6 tries.
Game
A pregnant patient at 28 weeks reports daily methamphetamine use. What is the MOST important immediate clinical concern?
How fast the unborn baby's pulse beats, monitored through labor for signs of trouble.
Diagnostic studies
A patient with sickle cell disease is admitted in labor. Which proactive plan BEST reduces risk of an obstetric emergency?
What is the earliest objective sign of maternal decompensation in obstetric sepsis that may precede hypotension?
Implicit ___: unconscious negative attitudes toward a group that can distort clinical decisions and widen maternal care gaps.
Health disparities
1.2 Dynamic Antepartum & Intrapartum Risk Assessment
A patient with a previous classical cesarean section presents in labor at 39 weeks. What is the MOST appropriate plan to prevent uterine rupture?
Swap tiles to line up three of the same term.
Term Match
Which patient is at HIGHEST risk for placenta accreta spectrum?
Emergency that occurs when insulin is too low to move sugar into cells, so the body burns fat and byproducts build up in the blood.
Medical emergencies
Per the AIM Severe Hypertension in Pregnancy bundle, which screening practice should occur on every obstetric admission?
Which laboratory finding is MOST suggestive of HELLP syndrome rather than uncomplicated severe preeclampsia?
Critical illness in which fluid fills the lungs' air sacs and surfactant breaks down, so oxygen cannot reach the blood.
1.3 Maternal Early Warning Systems (MEWS/MEWT) & Critical Triage Physical Assessment
A 32-week pregnant patient presents with sudden dyspnea and unilateral leg swelling. Which initial diagnostic study is MOST appropriate?
Flip two cards at a time to find matching terms.
Term Pairs
Which finding represents an EARLY sign of maternal decompensation that may precede frank shock?
Condition covering both deep-leg clots and clots that break loose and travel to the lungs.
Which patient population in the United States experiences the HIGHEST rates of severe maternal morbidity and mortality?
A patient with a BMI of 52 is admitted for induction. Which equipment-readiness step is MOST critical to prevent an emergency delay?
Sudden brain injury with one-sided numbness or weakness; most cases come from a clot blocking a vessel.
1.4 Alliance for Innovation on Maternal Health (AIM) Safety Bundles & Emergency Readiness
A patient at 36 weeks reports decreased fetal movement for 24 hours. What is the MOST appropriate first-line assessment?
Find five hidden terms in a grid of letters.
Term Search
Which feature of a Maternal Early Warning Trigger should prompt IMMEDIATE bedside provider evaluation?
___ presentation: the buttocks or feet, rather than the head, would come out first; it occurs in 3-4% of full-term births.
Intrapartum emergencies
A patient with peripartum cardiomyopathy diagnosed in last pregnancy is now 12 weeks pregnant with EF 38%. Which counseling point is MOST important?
Question · Hard
Which signs and symptoms of trauma should be screened for using a trauma-informed approach in every obstetric admission?
Umbilical ___: structure that can slide into the vagina ahead of the baby and be compressed.
Chapter 2: Obstetric Hemorrhage — Etiology, Assessment & Uterotonics
2.1 Postpartum Hemorrhage Etiology (4 T's) & Quantitative Blood Loss (QBL)
Which findings in a 26-week pregnant patient with vague abdominal pain should raise suspicion for a hepatic emergency?
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Which structural change in maternal anatomy makes airway management significantly more difficult after 20 weeks of gestation?
The body's overactive, extreme reaction to an infection, a life-threatening condition that can cause organ failure.
Maternal infection
A 30-week pregnant patient with type 1 diabetes presents with vomiting, glucose 380 mg/dL, pH 7.18, and ketones. What is the FIRST priority?
Medical Emergencies
A laboring patient with severe asthma develops audible wheezing, RR 32, SpO2 88%. After bronchodilators and steroids, what is the NEXT step?
Rare, often fatal collapse during labor or soon after birth, with sudden heart and breathing failure plus abnormal clotting.
Maternal resuscitation
2.2 Uterotonic Pharmacology & Stepwise Administration Protocols
A postpartum patient develops sudden chest pain, dyspnea, and bilateral pulmonary infiltrates with PaO2/FiO2 ratio of 180. Which diagnosis is MOST consistent with these findings?
A 34-week pregnant patient presents with crushing substernal chest pain and ECG showing ST elevation in leads II, III, aVF. What is the MOST appropriate immediate intervention?
Maternal ___: sudden stop of the heart; CPR and a defibrillator can be lifesaving.
Which symptom complex in a postpartum patient is MOST suggestive of acute aortic dissection?
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