A 29-year-old woman delivers vaginally at a rural hospital. Thirty minutes later she has heavy vaginal bleeding estimated at 1,200 mL, tachycardia and...

Question

A 29-year-old woman delivers vaginally at a rural hospital. Thirty minutes later she has heavy vaginal bleeding estimated at 1,200 mL, tachycardia and hypotension. The uterus is boggy. What is the most appropriate immediate management?

Accepted Answer

Uterine massage and administration of oxytocin, with preparation for further uterotonics and transfer if needed

Answer

Observation only because postpartum bleeding is expected

Answer

Start warfarin to prevent thrombosis

Answer

Delay treatment until haemoglobin is checked

Answer

Insert a urinary catheter only and wait for spontaneous resolution

ca-mccqe1 MCQ (SBA): Postpartum haemorrhage

A 29-year-old woman delivers vaginally at a rural hospital. Thirty minutes later she has heavy vaginal bleeding estimated at 1,200 mL, tachycardia and hypotension. The uterus is boggy. What is the most appropriate immediate management?