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Primary postpartum haemorrhage — DRCOG MCQ

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HardLabourPrimary postpartum haemorrhageDRCOG

A 35-year-old woman delivers vaginally after a prolonged second stage. Ten minutes later she has brisk vaginal bleeding, a soft enlarged uterus and pulse 108/min. The placenta appears complete. What is the most likely diagnosis?

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

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Correct answer: D — Uterine atony causing primary postpartum haemorrhage

Brisk bleeding within 24 hours of birth with a soft enlarged uterus is primary postpartum haemorrhage due to uterine atony. Retained tissue is a consideration, but the complete placenta and boggy uterus make atony the best answer. The pearl is that uterine tone on examination guides the first-line emergency response.

Reference: NICE NG235; RCOG Green-top Guideline No. 52