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Inpatient Obstetrical Certification NCC exam study guide
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Inpatient Obstetrical Certification NCC exam study guide
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Inpatient Obstetrical Certification NCCexam study guide
Leading cause of perinatal admissions to the ICU - ANS Hemorrhagic disorders
Percentage of deaths related to pregnancy related hemorrhages - ANS 17-25%
Most maternal deaths from obstetric hemorrhage after first trimester of pregnancy are due to -
ANS Placental abruption
Race most likely to die from post partum hemorrhage - ANS 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 - ANS 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 - ANS 48
Obstetric hemorrhage is defined as a TBL or more than - ANS 1000cc
The classic sign of placenta previa is - ANS 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 -
ANS Placenta previa
Risk factors for placenta previa - ANS 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. - ANS Do the ultrasound first
Fetal blood volume is - ANS 100ml/kg
Changes noted during significant blood loss - ANS 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 - ANS Initially,
tachycardia
Then bradycardia
Sinusoidal-fetal anemia, hypoxia and acidemia
Persistent late decelerations
Percentage of accreta among women with previa - ANS 5-10%
If patient has had 2 or more cesarean sections, the likelihood of an accreta is - ANS
Greater than 50%
Vasa previa - ANS Fetal vessels cross the placental membranes in the lower uterine
segment and cover the cervical os
Velamentous cord insertion - ANS Fetal vessels run across chorion and amnion without
protective Wharton's jelly before entering the placental surface
Succenturiate placenta - ANS One or more small accessory lobes of placental vascular
tissue in membranes that are attached to main placenta by fetal vessels
Hemolysis - ANS lysis of erythrocytes with the release of hemoglobin
HELLP - ANS 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 - ANS 72 hours
Classic symptom of placental abruption - ANS Painful vaginal bleeding after 20 weeks
gestation
Risk factors for placental abruption - ANS 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
ACOG standard for fetal monitoring for maternal abdominal trauma - ANS Minimum of 2-6
hours
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