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Postpartum haemorrhage — DIPIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesPostpartum haemorrhageDIPIMCDipIMC

A woman delivered 20 minutes ago and now has brisk vaginal bleeding. The uterus feels soft on palpation and she is becoming tachycardic.

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

Reveal the answer and explanation

Correct answer: A — Rub up a uterine contraction with fundal massage, give a uterotonic and arrange urgent transfer.

A soft uterus with postpartum bleeding suggests uterine atony, the commonest cause of primary postpartum haemorrhage, treated initially with fundal massage to rub up a contraction, a uterotonic such as oxytocin, resuscitation and urgent transfer. Passive observation risks rapid deterioration. Tranexamic acid is an adjunct rather than a substitute for treating the atony and transferring.

Reference: MBRRACE-UK