Uterine atony Quiz: Ace Your Exams
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A 34-year-old G1P1 woman is brought to the emergency department for evaluation of persistent vaginal bleeding 30 minutes after a prolonged labor and vaginal delivery at home. The placenta was delivered at home and was intact. Past medical history is unremarkable. Temperature is 37.0°C (98.6°F), heart rate is 90/min, respiratory rate is 16/min, blood pressure is 126/68 mm Hg, and oxygen saturation is 98% on room air. Physical examination shows no evidence of vaginal or cervical lacerations. The uterus is soft, boggy, and poorly contracted. There is continuous vaginal bleeding. Intravenous fluids are started. Uterine massage is attempted; however, the patient continues to have bleeding and a soft boggy uterus. Which of the following is the best next step in management?
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