Uterine atony — MCCQE Part 1 MCQ

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HardBleeding PostpartumUterine atonyMCCQE Part 1

A 29-year-old woman delivers vaginally and then develops heavy bleeding. The uterus is boggy above the umbilicus, pulse is 124/min, BP is 90/54 mmHg, and the placenta appears complete. What is the most likely diagnosis?

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Correct answer: B — Uterine atony

Postpartum haemorrhage with a boggy enlarged uterus and apparently complete placenta is most consistent with uterine atony. Retained placenta is suggested by missing placental tissue or failure of placental delivery. Uterine inversion causes shock with a fundal mass absent abdominally or visible vaginally. Vaginal haematoma causes pain and concealed bleeding rather than a boggy uterus.

Reference: SOGC postpartum haemorrhage guideline