CHAPTER 41: Obstetrical Hemorrhage

Obstetrical Hemorrhage

What is the most important cause of maternal mortality worldwide?

a. Infection

b. Hemorrhage

c. Pulmonary embolism

d. None of the above

b Introduction

Which of the following statements is accurate concerning postpartum hemorrhage?

a. The blood loss at delivery approaches the volume of blood added during pregnancy.

b. Studies show that estimated blood loss reported is often less than the actual blood loss.

c. The American College of Obstetricians and Gynecologists defines postpartum hemorrhage as cumulative blood loss of >100 mL accompanied by symptoms and signs of hypovolemia.

d. None of the above

b Definition and Incidence

Given the diagram below, which of the following statements is true?

Reproduced with permission from Cunningham FG, Leveno KJ, Bloom SL, et al (eds): Obstetrical hemorrhage. In Williams Obstetrics, 25th ed. New York, McGraw-Hill, 2018, Figure 41-1.

A bar graph compares the percent of cases with blood loss after vaginal delivery, repeat cesarean delivery and repeat cesarean with hysterectomy.

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a. Very few vaginal deliveries have blood loss less than 500 mL.

b. All cesarean hysterectomies have blood loss greater than 1000 mL.

c. A smaller percentage of vaginal deliveries have blood loss greater than 1000 mL than cesarean hysterectomies have blood loss less than 500 mL.

d. None of the above

d Definition and Incidence

For a woman measuring 5′0″ and 120 lb, what is her expected pregravid blood volume?

a. 3000 mL

b. 3250 mL

c. 3500 mL

d. 3800 mL

a Table 41-1

Assuming a 50% increase in the blood volume of a woman during pregnancy, what would the blood volume of a 5′2″ woman who weighed 140 lb pregravid be at term?

a. 4000 mL

b. 4340 mL

c. 4700 mL

d. 4930 mL

b Table 41-1

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