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Primary postpartum haemorrhage — RCPSC EM MCQ

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HardOB/GYN emergenciesPrimary postpartum haemorrhageRCPSC EM

A 29-year-old arrives 40 minutes after home delivery with heavy vaginal bleeding. The uterus is boggy above the umbilicus, HR is 128/min, BP is 86/48 mmHg, and estimated blood loss exceeds 1500 mL. What is the most appropriate next step?

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

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Correct answer: B — Begin uterine massage, oxytocin, massive haemorrhage protocol, and urgent obstetric help

Begin uterine massage, oxytocin, massive haemorrhage protocol, and urgent obstetric help is correct: the clues indicate Primary postpartum haemorrhage and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian obstetric haemorrhage emergency practice