Match each clinical presentation of postpartum bleeding to its appropriate management strategy:

Presentations:
1. Mild, settling bleeding with a non-tender uterus and no signs of sepsis
2. Heavy bleeding with suspected infected retained products of conception
3. Torrential, life-threatening bleeding during intrauterine evacuation
4. Suspected vascular anomaly (e.g., pseudoaneurysm or arteriovenous malformation)

Management Strategies:
A. Immediate escalation to laparotomy/major surgical intervention
B. Pelvic angiography and selective embolization
C. Conservative observation and outpatient/inpatient investigation
D. Hemodynamic resuscitation and surgical uterine exploration under anesthesia

Question

Match each clinical presentation of postpartum bleeding to its appropriate management strategy:

Presentations:
1. Mild, settling bleeding with a non-tender uterus and no signs of sepsis
2. Heavy bleeding with suspected infected retained products of conception
3. Torrential, life-threatening bleeding during intrauterine evacuation
4. Suspected vascular anomaly (e.g., pseudoaneurysm or arteriovenous malformation)

Management Strategies:
A. Immediate escalation to laparotomy/major surgical intervention
B. Pelvic angiography and selective embolization
C. Conservative observation and outpatient/inpatient investigation
D. Hemodynamic resuscitation and surgical uterine exploration under anesthesia

Accepted Answer

1-C, 2-D, 3-A, 4-B. The slides distinguish stable mild cases from heavy or infected presentations. They describe observation and investigation for selected stable patients, exploration and antibiotics where indicated, surgery for torrential bleeding, and angiography with embolization for suspected vascular lesions. **Key takeaway:** Match intervention intensity to severity and likely cause.

**Glossary:** **AV sinus**: an abnormal vascular communication or lesion.

Explanation

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