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Uterine atony causing postpartum haemorrhage — MCCQE Part 1 MCQ

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EasyPostpartum BleedingUterine atony causing postpartum haemorrhageMCCQE Part 1

A 27-year-old woman has heavy vaginal bleeding 10 minutes after an uncomplicated vaginal delivery. The placenta is complete, blood pressure is 96/60 mmHg, and the uterus feels boggy above the umbilicus. What is the most appropriate next step in management?

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

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Correct answer: APerform uterine massage and give oxytocin while initiating postpartum haemorrhage protocol

A boggy enlarged uterus immediately after delivery indicates uterine atony, the commonest cause of postpartum haemorrhage; uterine massage and oxytocin are first-line while activating haemorrhage support. Hysterectomy is a last-resort escalation after medical and conservative measures. Observation alone is unsafe in active haemorrhage.

Reference: https://mcc.ca/objectives/medical-experts/