Doc750
transfer:step 3 prison
Topics: 52
Posts: 634
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A 30 yr old woman with type I DM delivers a 4.3 kg (9lb 8oz) baby boy at 39 weeks gestation. The first stage of labor progressed without incident, but the second stage was markedly prolonged. The patient recieved epidural anesthesia, which controlled her pain well. Immediately after the delivery of an intact placenta, the patient continues to bleed vaginally, vital signs are significant for a bp of 120/70 mm Hg and a heart rate of 79/min. The patient is alert and conversant. Bimanual examination reveals a soft, enlarged, boggy uterus.
1) What is the most likely diagnosis?
2) What are the common risk factors for this condition?
3) What is the most appropriate initial treatment?
4) What is a good secondary treatment to add?
5) What options are available if initial management fails?
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 634
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this is an easy one .. come on "soft, enlarged boggy uterus" .. 
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| MAGY17
Forum Elite
Topics: 30
Posts: 234
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1=uterine atony
2=papid and protracted labor, chorioamnionitis, drugs, averdistended uterus.
3=massage
4=oxytocin
5=ARTERY LAGATION OR HYSTERECTOMY
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| dermatology
Forum Elite
Topics: 30
Posts: 297
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medical treatment :- oxytocin , methergin (CI in HT) , prostin ( CI in asthma) ---------> still bleeding ...rule out Retained POC by D and C.-----------> still bleeding uterine artery embolization ----.> pelvic vessel ligation and finally hysterectomy if no modalities are responsive .
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