05-12-2010, 05:09 AM
A 33-year-old woman, gravida 2, para 1, at term gives birth to a 4167-g (9 lb 3 oz) male newborn by a spontaneous 30-minute vaginal delivery. Shortly after delivery of the placenta, there is a brisk flow of blood from the uterus. Manual palpation of the uterine cavity shows a large fragment of retained placental material. A curettage shows a fibrous nodule of placental tissue that is firmly adherent to the uterine wall. Which of the following is the most likely cause of the bleeding in this patient?
A. Abruptio placentae
B. Choriocarcinoma
C. Factor XIII (transglutaminase) deficiency
D. Granulomatous endometritis
E. Placenta accreta
F. Placenta previa
A. Abruptio placentae
B. Choriocarcinoma
C. Factor XIII (transglutaminase) deficiency
D. Granulomatous endometritis
E. Placenta accreta
F. Placenta previa