In Pregnancy Flashcards

When performing CPR on a pregnant patient in cardiac arrest, what modification is most critical?

Answer: Manually displace the uterus to the left

Manual left uterine displacement relieves aortocaval compression and improves cardiac output during CPR.

At approximately what gestational age does the fundus reach the umbilicus?

Answer: 20 weeks

The fundal height in centimeters approximates gestational age in weeks, reaching the umbilicus at roughly 20 weeks.

Which breathing change is normal in pregnancy that may mimic respiratory distress?

Answer: Hyperventilation with reduced PaCO2

Progesterone-driven hyperventilation lowers maternal PaCO2 to 28–32 mmHg, which is normal in pregnancy.

A term pregnant patient is involved in a motor vehicle crash. She has no abdominal pain but vaginal bleeding is present. What condition should be highest on the differential?

Answer: Abruptio placentae

Abruptio placentae (placental abruption) is the most common serious obstetric complication following blunt abdominal trauma.

In a trauma patient at 36 weeks gestation, which finding best indicates significant hemorrhage despite vital signs appearing normal?

Answer: Fetal heart rate of 170 bpm

Fetal tachycardia (>160 bpm) can be an early indicator of maternal hypovolemia even before maternal vital signs deteriorate.

Which of the following is a late sign of hypovolemic shock specifically relevant to pregnant trauma patients?

Answer: Maternal hypotension

Pregnant patients can compensate for up to 1,500 mL blood loss before maternal hypotension appears, making it a late sign.

What is the recommended oxygen saturation target when providing supplemental oxygen to a critically injured pregnant patient?

Answer: Above 95%

Maintaining SpO2 above 95% helps ensure adequate fetal oxygenation, as fetal hemoglobin has a different oxygen dissociation curve.