A 27-year-old primigravida at 38 weeks delivers vaginally. The placenta is delivered by controlled cord traction but a succenturiate lobe is noted to be retained. She develops 600 mL bleeding with a contracted uterus. What is the definitive management?

• A Misoprostol per rectum
• B Uterine curettage
• C Oxytocin infusion alone
• D Manual removal under anesthesia ✓

Explanation

Retained placental tissue with active bleeding requires manual removal under anesthesia. Curettage risks uterine perforation in the immediate postpartum period. Oxytocin and misoprostol help atony but do not remove retained tissue. Manual removal is the definitive step per standard obstetric protocols.

Reference: Dutta's Textbook of Obstetrics, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.