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Cases Obstetrical
Cases Obstetrical
(7) A 31-year-old gravida 3 para 2 patient just had a vaginal delivery at 41 weeks
and 4 days of gestation. A midline episiotomy is performed in anticipation of a
macrosomic infant. She has no known drug allergies and an unremarkable family
history. Her 2 prior pregnancies ended in normal spontaneous vaginal deliveries at
term without notable complications.
Suddenly after vaginal delivery of a 4.100 kg male, a large quantity of blood gushes
from her vagina, and she continues to bleed profusely.
a) What is the first thing that should be done?
b) What is the sequence of steps that should be done in the management?
b) What is the medications that can be ordered?
c) If the patient’s hemorrhage is unresponsive to medical management; in addition to
infusing blood products, what are the surgical procedures to be performed control the
bleeding and preserve fertility?