A woman delivered vaginally 3 days ago. She now presents with continuous moderate vaginal bleeding and a temperature of 38.2°C. The uterus is palpable 2 cm above the umbilicus and tender. Lochia is foul-smelling. The most likely cause of her hemorrhage is:

• A Endometritis with uterine atony ✓
• B Retained products of conception
• C Cervical laceration
• D Coagulopathy

Explanation

Secondary PPH with fever, foul-smelling lochia, uterine tenderness, and subinvolution points to endometritis. Infection impairs uterine contraction and causes bleeding. Retained products alone would not cause fever and tenderness unless infected. Cervical laceration presents with immediate bright red bleeding postpartum.

Reference: High Risk Pregnancy: Management Options, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.