Inpatient Obstetrical Certification NCC (2023/2024) Already Passed

Inpatient Obstetrical Certification NCC (2023/2024) Already Passed Leading cause of perinatal admissions to the ICU Hemorrhagic disorders Percentage of deaths related to pregnancy related hemorrhages 17-25% Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to Placental abruption Race most likely to die from post partum hemorrhage 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 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 48 Obstetric hemorrhage is defined as a TBL or more than 1000cc The classic sign of placenta previa is 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 Placenta previa Risk factors for placenta previa 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. Do the ultrasound first Fetal blood volume is 100ml/kg Changes noted during significant blood loss 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 Initially, tachycardia Then bradycardia Sinusoidal-fetal anemia, hypoxia and acidemia Persistent late decelerations Percentage of accreta among women with previa 5-10% If patient has had 2 or more cesarean sections, the likelihood of an accreta is Greater than 50% Vasa previa Fetal vessels cross the placental membranes in the lower uterine segment and cover the cervical os Velamentous cord insertion Fetal vessels run across chorion