A 31-year-old woman presents to a regional ED, triage category 1, 45 minutes after home birth with ongoing heavy vaginal bleeding. BP 82/46, HR 142.

Question

A 31-year-old woman presents to a regional ED, triage category 1, 45 minutes after home birth with ongoing heavy vaginal bleeding. BP 82/46, HR 142. Uterus is boggy above the umbilicus and estimated blood loss is 1500 mL. What is the most important immediate action?

Accepted Answer

Uterine massage, oxytocin and massive haemorrhage response

Answer

Perform routine cervical screening

Answer

Give tocolysis and observe

Answer

Send home with oral iron

Answer

Arrange elective pelvic ultrasound

Primary postpartum haemorrhage — ACEM Fellowship MCQ

A 31-year-old woman presents to a regional ED, triage category 1, 45 minutes after home birth with ongoing heavy vaginal bleeding. BP 82/46, HR 142. Uterus is boggy above the umbilicus and estimated blood loss is 1500 mL. What is the most important immediate action?