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Postpartum hemorrhage — ABEM Board MCQ

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EasyOB/GYN emergenciesPostpartum hemorrhageABEM Board

A 28-year-old woman delivers in the ED and develops heavy vaginal bleeding. Triage acuity is ESI 1; BP 82/46 mm Hg, HR 142/min. The uterus is boggy above the umbilicus, and there are no vaginal lacerations seen. Placenta appears intact. Which of the following is the most likely diagnosis?

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Correct answer: A — Uterine atony causing postpartum hemorrhage

A boggy enlarged uterus with heavy bleeding after delivery indicates uterine atony, the most common cause of postpartum hemorrhage.

Reference: ACOG postpartum hemorrhage guidance