Inpatient Obstetrical Certification NCC
Exam Questions and Answers16
Leading cause of perinatal admissions to the ICU - ANSWERS-Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages - ANSWERS-17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to -
ANSWERS-Placental abruption
Race most likely to die from post partum hemorrhage - ANSWERS-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 - ANSWERS-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 - ANSWERS-48
Obstetric hemorrhage is defined as a TBL or more than - ANSWERS-1000cc
The classic sign of placenta previa is - ANSWERS-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 -
ANSWERS-Placenta previa
,Risk factors for placenta previa - ANSWERS-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. - ANSWERS-Do the ultrasound first
Fetal blood volume is - ANSWERS-100ml/kg
Changes noted during significant blood loss - ANSWERS-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 - ANSWERS-Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and acidemia
Persistent late decelerations
Percentage of accreta among women with previa - ANSWERS-5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is - ANSWERS-
Greater than 50%
, Vasa previa - ANSWERS-Fetal vessels cross the placental membranes in the lower uterine
segment and cover the cervical os
Velamentous cord insertion - ANSWERS-Fetal vessels run across chorion and amnion without
protective Wharton's jelly before entering the placental surface
Succenturiate placenta - ANSWERS-One or more small accessory lobes of placental vascular
tissue in membranes that are attached to main placenta by fetal vessels
Hemolysis - ANSWERS-lysis of erythrocytes with the release of hemoglobin
HELLP - ANSWERS-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 - ANSWERS-72 hours
Classic symptom of placental abruption - ANSWERS-Painful vaginal bleeding after 20 weeks
gestation
Risk factors for placental abruption - ANSWERS-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
Exam Questions and Answers16
Leading cause of perinatal admissions to the ICU - ANSWERS-Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages - ANSWERS-17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to -
ANSWERS-Placental abruption
Race most likely to die from post partum hemorrhage - ANSWERS-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 - ANSWERS-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 - ANSWERS-48
Obstetric hemorrhage is defined as a TBL or more than - ANSWERS-1000cc
The classic sign of placenta previa is - ANSWERS-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 -
ANSWERS-Placenta previa
,Risk factors for placenta previa - ANSWERS-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. - ANSWERS-Do the ultrasound first
Fetal blood volume is - ANSWERS-100ml/kg
Changes noted during significant blood loss - ANSWERS-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 - ANSWERS-Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and acidemia
Persistent late decelerations
Percentage of accreta among women with previa - ANSWERS-5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is - ANSWERS-
Greater than 50%
, Vasa previa - ANSWERS-Fetal vessels cross the placental membranes in the lower uterine
segment and cover the cervical os
Velamentous cord insertion - ANSWERS-Fetal vessels run across chorion and amnion without
protective Wharton's jelly before entering the placental surface
Succenturiate placenta - ANSWERS-One or more small accessory lobes of placental vascular
tissue in membranes that are attached to main placenta by fetal vessels
Hemolysis - ANSWERS-lysis of erythrocytes with the release of hemoglobin
HELLP - ANSWERS-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 - ANSWERS-72 hours
Classic symptom of placental abruption - ANSWERS-Painful vaginal bleeding after 20 weeks
gestation
Risk factors for placental abruption - ANSWERS-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
