Postpartum hemorrhage is classified into two groups: early postpartum hemorrhage and late postpartum hemorrhage.

What is the most common cause of early postpartum hemorrhage?

Uterine atony

Trauma

Lacerations

Hematomas

Answer and Explanation

The Correct Answer is A

Uterine atony is the most common cause of early postpartum hemorrhage, accounting for up to 80% of cases. Uterine atony is when the uterus fails to contract after delivery of the placenta, leading to excessive bleeding from the blood vessels where the placenta was attached.

Choice B is wrong because trauma is not the most common cause of early postpartum hemorrhage. Trauma accounts for about 20% of cases and includes uterine rupture, cervical and vaginal lacerations, and uterine inversion.

Choice C is wrong because lacerations are not the most common cause of early postpartum hemorrhage. Lacerations are a type of trauma that can cause bleeding from the cervix, vagina, or perineum.

Choice D is wrong because hematomas are not the most common cause of early postpartum hemorrhage. Hematomas are a type of trauma that can cause bleeding into the tissues of the vulva, vagina, or perineum.

Normal ranges for blood loss after delivery are less than 500 ml for vaginal delivery and less than 1000 ml for cesarean delivery. Postpartum hemorrhage is defined as blood loss greater than these amounts or when bleeding causes symptoms of hypovolemia (low blood volume) or hemodynamic instability (low blood pressure or high heart rate).

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Correct Answer is A

Explanation

Uterine atony is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases.It occurs when the uterus does not contract enough to stop the bleeding from the placental site.Uterine atony can be caused by factors such as prolonged labor, multiple pregnancy, large baby, infection or use of certain medications.

The other statements are wrong because:

• B.Retained placenta is the second most common cause of postpartum hemorrhage, but it only accounts for about 10% of cases.It occurs when part or all of the placenta remains attached to the uterine wall and prevents the uterus from contracting properly.

• C.Lacerations are tears or cuts in the cervix, vagina or perineum that can cause bleeding after delivery.They are usually minor and can be repaired with stitches, but they can also be severe and require surgery.Lacerations are not very common causes of postpartum hemorrhage, and they usually occur along with other factors such as uterine atony or retained placenta.

• D.Hematomas are collections of blood under the skin or in the tissues that can result from trauma during delivery.They can cause pain, swelling and pressure in the affected area, but they are usually small and resolve on their own.Hematomas are rare causes of postpartum hemorrhage, and they usually occur along with other factors such as lacerations or coagulation disorders.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal birth and less than 1000 mL for cesarean birth.Blood loss greater than these amounts can indicate postpartum hemorrhage and require immediate medical attention.

A. Grand multiparity B. Uterine overdistention C. Precipitous labor D. Oxytocin use E. Chorioamnionitis

Correct Answer is ["B","D","E"]

Explanation

The correct answer is choice B, D and E. These are the factors that put this client at risk for developing postpartum hemorrhage:

• Uterine overdistention: This occurs when the uterus is stretched too much by a large baby, multiple babies, or excess amniotic fluid.This can impair the normal contraction of the uterus after delivery and lead to bleeding.

• Oxytocin use: This is a hormone that stimulates uterine contractions during labor.However, prolonged or excessive use of oxytocin can cause uterine atony, which is the failure of the uterus to contract and compress the blood vessels after delivery.

• Chorioamnionitis: This is an infection of the membranes and amniotic fluid that surround the baby.It can cause inflammation and damage to the uterine lining, which can interfere with blood clotting and increase the risk of bleeding.

Choice A and C are wrong because:

• Grand multiparity: This means having given birth five or more times.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as uterine overdistention, oxytocin use, or placental abnormalities.

• Precipitous labor: This means having a very fast labor, lasting less than three hours.It is not a risk factor for postpartum hemorrhage by itself, but it may be associated with other risk factors such as trauma to the birth canal, retained placenta, or coagulation disorders.

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Postpartum hemorrhage is classified into two groups: early postpartum hemorrhage and late postpartum hemorrhage. What is the most common cause of early postpartum hemorrhage?

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Naxlex Comprehensive Predictor Exams

Which of the following is the most common cause of postpartum hemorrhage?

Correct Answer is A

Explanation

A nurse is caring for a client who experienced a postpartum hemorrhage after delivering a large baby following oxytocin induction of labor. Which of the following factors put this client at risk for developing postpartum hemorrhage? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to retained placental fragments. Which of the following interventions should the nurse anticipate? Select all that apply:

A nurse is caring for a client who delivered vaginally 4 hours ago and has a boggy uterus that is displaced to the right of midline. Which of the following actions should the nurse take first?

Which of the following laboratory tests should the nurse report to the obstetrician when monitoring a client who is one day postpartum and has experienced significant postpartum hemorrhage?

Which of the following is a risk factor for postpartum hemorrhage?

A nurse is preparing to administer methylergonovine to a client who has a postpartum hemorrhage due to uterine atony. Which of the following assessments should the nurse perform prior to administration?

A nurse is performing fundal massage for a client who has uterine atony and postpartum hemorrhage. Which of the following actions should the nurse take when performing this procedure?

A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to uterine atony. Which of the following medications should the nurse anticipate administering? Select all that apply:

A nurse is evaluating a client who had a postpartum hemorrhage and received fluid resuscitation and blood transfusion therapy. Which of the following findings indicates an improvement in the client’s condition?

Postpartum hemorrhage is classified into two groups: early postpartum hemorrhage and late postpartum hemorrhage.

What is the most common cause of early postpartum hemorrhage?