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Obstetrical Trauma
What are the hemodynamic changes in pregnancy? - Correct
answer- Increased HR (10-15 bpm), blood volume with
dilutional anemia (45%), and CO (30%); decreased BP due to
low SVR (progesterone).
What puts pregnant women at risk for fall? - Correct answer-
Gravity shifts forward; relaxin production results in joint
hyper-mobility.
What position should a pregnant woman be placed in to reduce
the effect of aortocaval compression? - Correct answer- Left
lateral tilt
Up to how much blood loss can a pregnant woman have
without little changes in vital signs? - Correct answer- Up to 2L
What are the pulmonary changes in pregnancy and what are
the clinical considerations? - Correct answer- Engorged
mucosa; increased O2 consumption with decreased reserve,
increased Vt and MVe; consider early intubation with smaller
than average ET tube.
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What can mimic neurological injury in a pregnant trauma
patient and how does it present? - Correct answer- Pre-
eclampsia; presents as acute hypertension, edema, and
seizures; treat with magnesium and antihypertensives.
What are the GI changes in pregnancy and their clinical
implications? - Correct answer- Decreased gastric motility and
relaxation of esophageal and gastric sphincters (increased risk
for aspiration).
What are the GU changes in pregnancy and their clinical
implications? - Correct answer- Increased perfusion to pelvis
(risk for hemorrhage) and increased bladder pressure (risk for
rupture).
Which assessment comes first? Mother or fetus? - Correct
answer- Mother; aggressive care for the mother gives the fetus
the greatest chance for survival.
Concerns for chest tubes, volume replacement in the unstable
patient, and vasopressors? - Correct answer- Chest tubes
should be placed 1-2 interspaces higher than usual; PRBCs are
preferred for resuscitation; avoid pressors as they decrease
uterine and placental perfusion.
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Obstetrical Trauma
What are the hemodynamic changes in pregnancy? - Correct
answer- Increased HR (10-15 bpm), blood volume with
dilutional anemia (45%), and CO (30%); decreased BP due to
low SVR (progesterone).
What puts pregnant women at risk for fall? - Correct answer-
Gravity shifts forward; relaxin production results in joint
hyper-mobility.
What position should a pregnant woman be placed in to reduce
the effect of aortocaval compression? - Correct answer- Left
lateral tilt
Up to how much blood loss can a pregnant woman have
without little changes in vital signs? - Correct answer- Up to 2L
What are the pulmonary changes in pregnancy and what are
the clinical considerations? - Correct answer- Engorged
mucosa; increased O2 consumption with decreased reserve,
increased Vt and MVe; consider early intubation with smaller
than average ET tube.
1
, 2
What can mimic neurological injury in a pregnant trauma
patient and how does it present? - Correct answer- Pre-
eclampsia; presents as acute hypertension, edema, and
seizures; treat with magnesium and antihypertensives.
What are the GI changes in pregnancy and their clinical
implications? - Correct answer- Decreased gastric motility and
relaxation of esophageal and gastric sphincters (increased risk
for aspiration).
What are the GU changes in pregnancy and their clinical
implications? - Correct answer- Increased perfusion to pelvis
(risk for hemorrhage) and increased bladder pressure (risk for
rupture).
Which assessment comes first? Mother or fetus? - Correct
answer- Mother; aggressive care for the mother gives the fetus
the greatest chance for survival.
Concerns for chest tubes, volume replacement in the unstable
patient, and vasopressors? - Correct answer- Chest tubes
should be placed 1-2 interspaces higher than usual; PRBCs are
preferred for resuscitation; avoid pressors as they decrease
uterine and placental perfusion.
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