Large Clots in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#594
SMLE Question #594
Obstetrics & Gynecology
General Gynecology
Last updated: February 2026
A 29-year-old G2P2 woman delivers vaginally at term after an uncomplicated labor. Ten minutes after placental delivery, she develops heavy vaginal bleeding with large clots. She is pale and diaphoretic, and the uterus feels boggy and enlarged above the umbilicus. Bimanual uterine massage and high-dose oxytocin infusion are started, but bleeding persists and hypotension continues despite 1.5 L of crystalloid. What is the most likely life-threatening complication if this bleeding is not rapidly controlled?
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