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An 18-year-old primigravid woman vaginally delivers a 3100-g (6-lb 13-oz) term newborn. Pregnancy and delivery were uncomplicated. The placenta is spontaneously delivered intact 8 minutes after delivery of the newborn. Two minutes after delivery of the placenta, the patient has vaginal bleeding resulting in the loss of 800 mL of blood. Physical examination should specifically focus on which of the following?
A) The cervix
B) The consistency of the blood
C) The patient's mental status
D) The placenta
E) The uterus
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focus on placenta if any part is missing
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I think the question stated that the placenta was spontaneously delivered and intact. Here they probably wants us to think about the most common cause of PPH, which is uterine atony, and you have to examin the abdomen and to perform abdominal massage, and to give oxytocin. I agree with E.
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@ nbme9999
it says :
Two minutes after delivery of the placenta, the patient has vaginal bleeding resulting in the loss of 800 mL of blood. ( so just after 2 min saying just delivered placenta , you cant go straight to uterus ).
So was never mention 'intact" , otherwise i would agree. Thats why they asking spcific focus on PEx and not not 'whats most common cause"
We start from confirming intact placenta , after focusing on uterus and massaging it
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The placenta is spontaneously delivered ( intact) 8 minutes. Is this not enough to rule out placenta problems ?
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Yes it is , my bed !
The placenta is spontaneously delivered intact 8 minutes after delivery of the newborn. ( rules out placental problems )
E) is the best bet
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@ snaggletooth77,I am looking for sp to discuss NBMEs plz add me if interested skype Alomstdone.
thanx
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Ldahab my time constraints prevent me from participating but thx for extending the opportunity. Just have a solid knowledge base/foundation 4 exam and you will certainly crush the board
