No Genital Tract Lacerations in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#11885
SMLE Question #11885
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 27-year-old G2P2 woman has a spontaneous vaginal delivery at term. Ten minutes after placental delivery, she develops brisk vaginal bleeding despite uterine massage, oxytocin, and misoprostol. Estimated blood loss is 1500 mL. Examination shows an enlarged, boggy uterus with no genital tract lacerations. Bimanual uterine compression temporarily reduces bleeding. She continues to hemorrhage despite IV fluids, and an urgent fertility-sparing procedure is needed. What is the most appropriate first-line surgical intervention?
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