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Postpartum haemorrhage from uterine atony — MCCQE Part 1 MCQ

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ModeratePostpartum BleedingPostpartum haemorrhage from uterine atonyMCCQE Part 1

A 30-year-old woman has heavy vaginal bleeding immediately after vaginal delivery. The uterus is boggy and enlarged; placenta appears complete. Which of the following is the most appropriate first-line treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Uterine massage and oxytocin with simultaneous resuscitation

A boggy uterus after delivery indicates uterine atony, the most common cause of postpartum haemorrhage. Immediate uterine massage, oxytocin and resuscitation are first-line. Tocolysis would worsen atony, and waiting risks haemorrhagic shock.

Reference: SOGC postpartum haemorrhage guidance