Antepartum and Postpartum Haemorrhage, Morbidly Adherent Placenta and Peripartum Collapse — WACS Viva & Clinical Scenarios (Obstetrics & Neonatal Care)

Exam-style antepartum and postpartum haemorrhage, morbidly adherent placenta and peripartum collapse viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 34-year-old G4P3 at 36 weeks gestation with two previous scars presents with sudden unprovoked painless vaginal bleeding soaking her clothes. On arrival, BP is 80/45 mmHg, HR 140 bpm, cold peripheries, and foetal heart sounds are 100 bpm. Ultrasonography confirms a major anterior placenta praevia. The obstetric team decides on an immediate emergency Caesarean section. Detail your anaesthetic induction, fluid resuscitation, and intraoperative management.
• SCENARIO 2: A 26-year-old primigravida undergoes uneventful vacuum delivery of a 4.2 kg infant. Twenty minutes later, brisk continuous vaginal haemorrhage occurs. Despite uterine massage and 20 IU oxytocin infusion, blood loss exceeds 1800 mL. BP is 70/35 mmHg, HR 150 bpm, SpO₂ 91%. The obstetrician requests transfer to theatre for urgent exploratory laparotomy. How do you direct resuscitation, airway control, and anaesthetic care?
• SCENARIO 3: A 31-year-old G3P2 with antenatally diagnosed placenta percreta invading the posterior bladder wall is scheduled for an elective Caesarean hysterectomy at 35 weeks gestation. Outline your pre-operative preparation, vascular access, choice of anaesthetic technique, blood conservation strategies, and massive transfusion planning.
• SCENARIO 4: During an uncomplicated elective Caesarean delivery under spinal anaesthesia, immediately following placental delivery, a 29-year-old mother suddenly gasps, becomes acutely cyanotic, convulses, and loses consciousness. Her carotid pulse is impalpable and the monitor shows pulseless electrical activity. What is your immediate diagnostic hypothesis, resuscitation protocol, and maternal-foetal crisis management?