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Postpartum haemorrhage — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesPostpartum haemorrhageDIPIMCDipIMC

After a home birth a woman has brisk vaginal bleeding. The uterus feels soft and boggy on palpation and she is becoming hypotensive.

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

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Correct answer: E — Rub up the fundus, give a uterotonic such as oxytocin, gain intravenous access with fluids and tranexamic acid, and transport

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

A soft, boggy uterus indicates uterine atony, the commonest cause of postpartum haemorrhage, treated by rubbing up the fundus, giving a uterotonic such as oxytocin, establishing access with fluids and tranexamic acid, and transferring. A pelvic binder (A) is irrelevant to obstetric bleeding. Address the atonic uterus directly while resuscitating, and remember the four Ts of postpartum haemorrhage.

Reference: JRCALC Clinical Guidelines; obstetric haemorrhage guidance