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Primary postpartum haemorrhage — RCPSC EM MCQ

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HardOB/GYN emergenciesPrimary postpartum haemorrhageRCPSC EM

CTAS 1: A patient delivered vaginally at home 45 minutes ago and arrives with heavy bleeding. Vitals are BP 84/46, HR 138. The uterus is boggy above the umbilicus and placenta appears complete. Two IVs and massive transfusion are being prepared. What is the most appropriate next step?

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Correct answer: D — Uterine massage with oxytocin and obstetric haemorrhage activation

Postpartum haemorrhage from uterine atony requires immediate uterine massage, uterotonics, resuscitation and obstetric escalation.

Reference: SOGC postpartum haemorrhage guidance; obstetric emergency practice