QuestionSBA
QuestionChoice
This answer is incorrect. Gestational diabetes mellitus is not a recognised cause of PPH.
10007450
e
Gestational diabetes mellitus
QuestionChoice
This answer is incorrect. Retained placental tissue more commonly causes secondary PPH (24 hours - 12 weeks postpartum). As the placenta was complete on examination following delivery, this makes retained placental tissue unlikely.
10007448
c
Retained placental tissue
QuestionChoice
This answer is incorrect. Whilst she had an episiotomy, it was successfully sutured after delivery, making vaginal trauma the cause of her PPH less likely.
10007447
b
Vaginal trauma
QuestionChoice
This answer is correct. Uterine atomy is the most common cause of primary PPH. This patient's advanced maternal age, long labour and first baby are all risk factors for uterine atony.
10007446
a
Uterine atony
QuestionChoice
This answer is incorrect. Infection more commonly causes secondary PPH (24 hours - 12 weeks postpartum).
10007449
d
Infection
Concept
Chapter
2693
4597
Postpartum haemorrhage
Topic
174
Obstetrics
14036
A 42-year-old woman delivers her baby vaginally on the labour ward. During her pregnancy, she had diet-controlled gestational diabetes mellitus, but no other issues.

This is her first baby and she was in labour for 22 hours. She required an episiotomy to aid delivery of the fetal head, which was successfully sutured after delivery. She had an active third stage of labour and delivered the placenta shortly after delivery of the baby. The midwife checks the placenta and reports that is it complete.

In the 24 hours following delivery, she loses 1200ml blood.

Which of the following is the most likely cause of her postpartum haemorrhage (PPH)?
a