08-16-2014, 01:04 PM
A 35-year-old G4P3 woman delivers a viable boy via a normal spontaneous vaginal delivery without complication. Infant weight is 4.19 kg (9.23 lb) and length is 52 cm (20.47 in); 1- and 5-minute Apgar scores are 8 and 9, respectively. The perineum is intact and the placenta is delivered 3 minutes after birth. The placenta appears intact and a three-vessel cord is identified. Shortly after delivery of the placenta, heavy vaginal bleeding begins. The patient appears pale and diaphoretic. Her pulse is 120/min and blood pressure is 90/60 mm Hg. Bimanual examination reveals a globular mass in the vagina consistent with an inverted uterine fundus.
What is the most important next step in management?
A.Administer terbutaline sulfate
B.General anesthesia
C.Manual attempt at uterine replacement
D.Start vasopressors
E.Surgical replacement of the uterus
What is the most important next step in management?
A.Administer terbutaline sulfate
B.General anesthesia
C.Manual attempt at uterine replacement
D.Start vasopressors
E.Surgical replacement of the uterus