There is a baby in the neonatal intensive care unit (NICU) who is exhibiting signs of neonatal abstinence syndrome. Which of the following medications are contraindicated for this neonate?

Choice A rationale

Uterine prolapse involves the descent of the uterus into the vaginal canal and is not a direct fatal complication of postpartum hemorrhage. It primarily stems from weakened pelvic floor muscles or ligament damage.

Choice B rationale

Von Willebrand’s disease is a hereditary bleeding disorder related to factor VIII and von Willebrand factor deficiencies, predisposing individuals to bleeding. It is not a direct result of prolonged postpartum hemorrhage.

Choice C rationale

Preeclampsia is a hypertensive disorder associated with proteinuria and organ dysfunction during pregnancy, not a postpartum hemorrhage complication. It can lead to significant morbidity but is unrelated to hemorrhagic complications.

Choice D rationale

Disseminated Intravascular Coagulation (DIC) is a life-threatening condition involving widespread coagulation and fibrinolysis, leading to uncontrolled bleeding, often triggered by severe postpartum hemorrhage. Laboratory findings may include low platelets, prolonged PT/INR, and elevated D-dimer.

Choice A rationale

A soft uterus indicates uterine atony, a complication rather than a normal finding. Daily fundal palpation ensures involution but should result in a firm, not soft, uterus.

Choice B rationale

Passage of clots is common postpartum, but ongoing monitoring for excessive clotting is crucial as it may indicate retained placental fragments or incomplete uterine involution.

Choice C rationale

Decreased lochia does not indicate complications unless it is completely absent, which may suggest uterine or cervical obstruction and warrants further evaluation.

Choice D rationale

Increased lochia or bright red bleeding signifies secondary postpartum hemorrhage, often caused by retained placental tissue or subinvolution, requiring immediate medical attention.