Postpartum Hemorrhage – Hard Case Based MCQs
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1. A 28-year-old woman develops massive bleeding immediately after delivery. Uterus is soft and enlarged despite oxytocin infusion. BP 80/50 mmHg. Best next step?
Uterine curettage
Bimanual uterine massage and carboprost
Internal iliac artery ligation
Immediate hysterectomy
2. After vaginal delivery, bleeding continues despite firm uterus. Examination reveals a large paravaginal swelling. Diagnosis?
Uterine atony
Retained placental tissue
Genital tract hematoma
DIC
3. Tranexamic acid in PPH reduces mortality when given within?
30 minutes
1 hour
3 hours
6 hours
4. A woman with asthma develops PPH due to uterine atony. Which drug is contraindicated?
Oxytocin
Methylergometrine
Misoprostol
Carboprost
5. Despite uterotonics and balloon tamponade, bleeding persists. Woman is unstable and family completed. Best definitive management?
Uterine artery embolization
B-Lynch suture
Subtotal hysterectomy
Observation
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