This page is dedicated to organizing various examples of standardized exam questions whose answer is postpartum hemorrhage (PPH). While this may seem a odd practice, it is useful to see multiple examples of how postpartum hemorrhage (PPH) will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 40 year old woman, G1P0, is at 39 weeks gestation. She comes to the hospital for the induction of labor. Her past medical history is significant for hypertension which is treated with nifedipine and asthma that is managed with an albuterol inhaler. Upon being admitted, her blood pressure is 140/75 mm Hg and her pulse is 95/min. After undergoing a prolonged labor, she delivers a healthy 8.5 lb girl with a force assisted vaginal delivery. After the delivery , the placenta is avulsed when excessive traction is placed on the cord. This requires that the placenta is manually extracted in pieces. After its removal, an ultrasound is conducted and shows a think endometrial stripe. About 1 hour after the delivery the patient bleeds through her perennial pad. During the bimanual examination a large volume of clotted blood is expressed from he lower uterine segment. Palpating the abdomen reveals a uterus that is soft, and is 4 cm above the umbilicus. What is the likely diagnosis in this patient?
Explanation: large amount of bleeding + soft/enlarged uterus = postpartum hemorrhage (PPH) (in this case it is likely caused by uterine atony given the size soft and enlarged uterus)
Page Updated: 10.13.2016