Inpatient Obstetrical Certification NCC
Exam-Graded A
Leading cause of perinatal admissions to the ICU - ANSWER-Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages - ANSWER-17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are
due to - ANSWER-Placental abruption
Race most likely to die from post partum hemorrhage - ANSWER-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 - ANSWER-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 -
ANSWER-48
Obstetric hemorrhage is defined as a TBL or more than - ANSWER-1000cc
The classic sign of placenta previa is - ANSWER-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 - ANSWER-Placenta previa
Risk factors for placenta previa - ANSWER-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. - ANSWER-Do the ultrasound first
Fetal blood volume is - ANSWER-100ml/kg
Changes noted during significant blood loss - ANSWER-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 - ANSWER-Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and acidemia
Persistent late decelerations
Percentage of accreta among women with previa - ANSWER-5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is -
ANSWER-Greater than 50%
Vasa previa - ANSWER-Fetal vessels cross the placental membranes in the lower
uterine segment and cover the cervical os
Velamentous cord insertion - ANSWER-Fetal vessels run across chorion and amnion
without protective Wharton's jelly before entering the placental surface
Succenturiate placenta - ANSWER-One or more small accessory lobes of placental
vascular tissue in membranes that are attached to main placenta by fetal vessels
Polyhydramnios is an AFI of greater than_______cm of amniotic fluid. - ANSWER-25
cm which equals 2000 ml
Normal AFI at term is - ANSWER-10-24 cm of fluid.
Low normal AFI at term is - ANSWER-5-9.9 cm of fluid
___________% of newborns have a major anomaly - ANSWER-1-2
Fetal lung maturity is determined by an amniocentisis. The lab test is called the
_________ratio. - ANSWER-L/S ratio. The lecithin/sphingomyelin ratio. The chance of
lung maturity is 98% if the concentration of lecithin is twice that of the sphingomyelin.
L/S ratio is not a valid indicator of lung maturity if the mother is diabetic. In diabetic
mothers, the presence of _______is highly predictive of fetal lung maturity. - ANSWER-
PG (phosphatidylglycerol)
Definitive fetal lung maturity testing requires - ANSWER-L/S ratio greater than 2:1 AND
the presence of PG
Exam-Graded A
Leading cause of perinatal admissions to the ICU - ANSWER-Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages - ANSWER-17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are
due to - ANSWER-Placental abruption
Race most likely to die from post partum hemorrhage - ANSWER-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 - ANSWER-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 -
ANSWER-48
Obstetric hemorrhage is defined as a TBL or more than - ANSWER-1000cc
The classic sign of placenta previa is - ANSWER-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 - ANSWER-Placenta previa
Risk factors for placenta previa - ANSWER-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. - ANSWER-Do the ultrasound first
Fetal blood volume is - ANSWER-100ml/kg
Changes noted during significant blood loss - ANSWER-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 - ANSWER-Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and acidemia
Persistent late decelerations
Percentage of accreta among women with previa - ANSWER-5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is -
ANSWER-Greater than 50%
Vasa previa - ANSWER-Fetal vessels cross the placental membranes in the lower
uterine segment and cover the cervical os
Velamentous cord insertion - ANSWER-Fetal vessels run across chorion and amnion
without protective Wharton's jelly before entering the placental surface
Succenturiate placenta - ANSWER-One or more small accessory lobes of placental
vascular tissue in membranes that are attached to main placenta by fetal vessels
Polyhydramnios is an AFI of greater than_______cm of amniotic fluid. - ANSWER-25
cm which equals 2000 ml
Normal AFI at term is - ANSWER-10-24 cm of fluid.
Low normal AFI at term is - ANSWER-5-9.9 cm of fluid
___________% of newborns have a major anomaly - ANSWER-1-2
Fetal lung maturity is determined by an amniocentisis. The lab test is called the
_________ratio. - ANSWER-L/S ratio. The lecithin/sphingomyelin ratio. The chance of
lung maturity is 98% if the concentration of lecithin is twice that of the sphingomyelin.
L/S ratio is not a valid indicator of lung maturity if the mother is diabetic. In diabetic
mothers, the presence of _______is highly predictive of fetal lung maturity. - ANSWER-
PG (phosphatidylglycerol)
Definitive fetal lung maturity testing requires - ANSWER-L/S ratio greater than 2:1 AND
the presence of PG
