The postpartum woman is experiencing heavy lochia and has required frequent fundal massage over the past 24- hour period.
Which of the following factors may have contributed to the uterine atony?

Choice A rationale
A negative pregnancy test is not the priority in this case. While it’s important to rule out pregnancy as a cause of abnormal uterine bleeding (AUB), it’s not the most critical finding.

Choice B rationale
A prothrombin time of 40 seconds is significantly prolonged, indicating a potential coagulation disorder. This could explain the abnormal uterine bleeding and should be prioritized due to the risk of significant blood loss.
Choice C rationale
A hemoglobin level of 10.1 g/dl is slightly low but within acceptable limits for many individuals. While it could indicate some degree of anemia possibly due to chronic blood loss, it’s not as immediately concerning as a coagulation disorder.
Choice D rationale
A serum cholesterol level of 140 mg/dl is within the normal range and is not directly related to AUB1.

Choice A rationale
Prolongation of the luteal phase is not the primary action of Pergonal (Menotropins). The luteal phase is part of the menstrual cycle, and while hormones do regulate it, Pergonal’s primary function is not to extend this phase.
Choice B rationale
Pergonal (Menotropins) is used to stimulate ovulation. It contains follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are essential for ovulation. FSH stimulates the growth and maturation of ovarian follicles, and LH triggers ovulation and the development of the corpus luteum.
Choice C rationale
Suppression of menstruation is not an expected action of Pergonal. This medication is used to promote ovulation, not to stop menstrual periods.
Choice D rationale
While hormonal changes during the menstrual cycle can affect cervical mucus production, the primary action of Pergonal is not to promote cervical mucus production. Its main role is to stimulate ovulation.