27-year-old Primigravida in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#16607

SMLE Question #16607

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 27-year-old primigravida delivers vaginally at term. Within 30 minutes postpartum, she develops heavy vaginal bleeding estimated at >700 mL. Bimanual uterine massage and uterotonic therapy (oxytocin and prostaglandin analogs) do not control the bleeding. The obstetrician proceeds to operative management, and the patient wishes to preserve future fertility. Which structure should be ligated to most appropriately control the bleeding while preserving fertility?

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