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Secondary postpartum haemorrhage — DRCOG MCQ

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ModeratePostnatalSecondary postpartum haemorrhageDRCOG

A 29-year-old woman presents 12 days after vaginal birth with heavy fresh bleeding and cramping pain. She feels light-headed and has a temperature of 38.2°C. Her pregnancy and delivery were otherwise uncomplicated. What is the most appropriate management?

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Correct answer: B — Arrange urgent hospital assessment for secondary postpartum haemorrhage

Heavy bleeding after 24 hours and within 12 weeks postpartum suggests secondary postpartum haemorrhage, especially with fever and systemic symptoms. Urgent assessment is needed for haemodynamic status, infection and retained products. Reassurance or delayed contraception review would be unsafe. Tranexamic acid may be part of management but should not delay urgent assessment in a symptomatic patient.

Reference: NICE NG194; RCOG Green-top Guideline No. 52