Approach to postpartum hemorrhage Quiz: Ace Your Exams

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A 27-year-old G1P1 woman is evaluated for vaginal bleeding immediately following a spontaneous vaginal delivery of a baby girl at 37 weeks gestation. This is the patient's first delivery, and her pregnancy has been uncomplicated. The placenta is delivered, and on inspection, it is noted to have velamentous vessels present. The patient has no previous medical history. Temperature is 37°C (98.6°F), blood pressure is 107/67 mmHg, pulse is 101/min, respiratory rate is 20/min, and oxygen saturation is 99% on room air. Examination of the perineum does not reveal evidence of trauma to the vaginal tissue, and no hematomas are present. There is no evidence of trauma to the cervix. On bimanual examination, the uterus is firm. Which of the following findings is most likely to be found on further clinical evaluation?  

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