A 35-year-old G4P3 woman delivers a viable boy via - resi_hopeful

[ArchivalUser]

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

[ArchivalUser]

c is it

[ArchivalUser]

yes that is correct
but why isnt it D
bp is so low.wuding u control bp first.

[ArchivalUser]

its like in shock due to tension pnemo
you insert the needle first then correct the others ..else its like a dead end--if I may say this way
place the uterus back in then oxytocin I think will take care of it
hope iam correct

[ArchivalUser]

fluid resuscitation should done instead of vasopressors.

[ArchivalUser]

img is right..
vasopressors only after fluids...

good job guys, keep these discussion going... im gonna start psychiatry...