Large Clots in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#1604
SMLE Question #1604
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 27-year-old G2P2 has a spontaneous vaginal delivery of a 3.7-kg neonate. Ten minutes after placental delivery, she develops heavy vaginal bleeding with large clots. The uterus is boggy. Bleeding persists despite uterine massage, bimanual compression, oxytocin infusion, tranexamic acid, and additional uterotonics. Two large-bore IV cannulas are in place and crystalloids are running. What is the most appropriate next step to control the hemorrhage?
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