Postpartum haemorrhage from uterine atony — MCCQE Part 1 MCQ

Correct answer: D — Call for help, massage the uterus and give uterotonic therapy while resuscitating

Call for help, massage the uterus and give uterotonic therapy while resuscitating is the single best answer because the age, timing, examination findings and investigations in the vignette fit Postpartum haemorrhage from uterine atony better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to SOGC postpartum haemorrhage guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: SOGC postpartum haemorrhage guidance