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Postpartum haemorrhage — DipIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesPostpartum haemorrhageDipIMC

A 35-year-old woman delivers at home and has heavy vaginal bleeding with a boggy uterus. She is pale, pulse 130 and blood pressure 86/52. What is the most appropriate immediate action?

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

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Correct answer: E — Massage the uterus, manage ABCs and arrange urgent obstetric transfer

A boggy uterus with heavy postpartum bleeding suggests uterine atony and postpartum haemorrhage. Uterine massage, resuscitation, warming and urgent transfer are priorities, with uterotonic drugs according to local scope. Waiting or hot bathing risks worsening haemorrhage. The pearl is that postpartum haemorrhage is often visible and rapidly fatal without basic early action.

Reference: JRCALC Guidelines 2025; RCOG Postpartum Haemorrhage guidance