A postpartum patient has a firm uterus but continued heavy vaginal bleeding. What should be considered?
- AUterine atony requiring continued fundal massage
- BNormal lochia rubra for the first postpartum day
- CGenital tract laceration or another bleeding source
- DBladder distention displacing the uterus
Show answer and explanations
Answer
C
A
A firm uterus argues against atony, so massage alone will not stop this bleeding.
B
Heavy continuous bleeding exceeds normal lochia rubra.
C
Persistent bleeding with a firm uterus suggests a laceration, hematoma, or coagulopathy.
D
A distended bladder causes a displaced, often boggy uterus; the uterus here is firm.