POSTPARTUM HEMORRHAGE MAIN EXAMINATION
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔What is boggy uterus? - ✔✔uterus that is soft and pliable on palpation
✔✔What can temporarily contract the uterus that is not meds? - ✔✔Massaging of the
uterus
✔✔2. Managing Uterine Atony - ✔✔
✔✔What is the third stage of labor? - ✔✔Period between delivery of the fetus and
delivery of the placenta
✔✔What is incidence of PPH reduced by when active management of the 3rd stage of
labor is done? - ✔✔70% reduction in PPH
✔✔What is the protocol for Management of the third stage of labor ? - ✔✔1. Oxytocin
infusion immediately after delivery of the infant or its ant shoulder
2. Gentle cord traction
3. Uterine Massage
✔✔What should be done initially if uterine atony is dx before starting other treatment
modalities? - ✔✔Bimanual Uterine Massage
✔✔What is Bimanual Uterine Massage - ✔✔Done for uterine atony that causes PPH
1. One hand compresses the uterus externally throguh the abd wall
2. Other hand is inserted so that the pressure can be placed against the anterior lower
uterine segment
✔✔What is the Medical manaement of uterine atony? - ✔✔Uterotonic Agents
✔✔What are the different uterotonic agents? - ✔✔1. Oxytocin
2. Methylergonovine maleare
3. misoprostol(prostaglandin E1)
4. Dinoprostone(Prostaglandin E2)
5. 15-methyl prostaglandin F2alpha
, ✔✔What is Methylergonovine maleate? - ✔✔causes uterine contractions within several
minutes
GIVEN IM
✔✔How is 15 methyl prostaglandin F2 alpha given? - ✔✔Given IM or direct to
myometrium
✔✔How can Dinoprostone given? - ✔✔rectal suppository
✔✔What is surgical management of Uterine atony options? - ✔✔Compression sutures
sequential artery ligation
selective arterial embolization
Hysterectomy
✔✔What surgical technique has best success rates of managing Uterine atony? -
✔✔Compression Sutures
✔✔What are Compression sutures? - ✔✔B lynch or multiple squares
they will wrap around the uterus and compress it all together
✔✔B lynch suture pic - ✔✔
✔✔What complication can be seen from periurethral laceractions from pregnancy? -
✔✔urinary retention
✔✔3. Retained Placenta - ✔✔
✔✔What facilitates separation of the Placenta and uterus? - ✔✔contractrion of the
uterus
✔✔What areas are cleaved between placenta and uterus from uterine contractions? -
✔✔Cleavage of the zona basalis and the zona spongiosa
✔✔After the placenta is separated what will happen? - ✔✔expulsion through strong
uterine contractions
✔✔What can remaining placental tissue in uterus cause? - ✔✔disrupts uterine
contraction efficacy thus leading to excessive bleeding
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔What is boggy uterus? - ✔✔uterus that is soft and pliable on palpation
✔✔What can temporarily contract the uterus that is not meds? - ✔✔Massaging of the
uterus
✔✔2. Managing Uterine Atony - ✔✔
✔✔What is the third stage of labor? - ✔✔Period between delivery of the fetus and
delivery of the placenta
✔✔What is incidence of PPH reduced by when active management of the 3rd stage of
labor is done? - ✔✔70% reduction in PPH
✔✔What is the protocol for Management of the third stage of labor ? - ✔✔1. Oxytocin
infusion immediately after delivery of the infant or its ant shoulder
2. Gentle cord traction
3. Uterine Massage
✔✔What should be done initially if uterine atony is dx before starting other treatment
modalities? - ✔✔Bimanual Uterine Massage
✔✔What is Bimanual Uterine Massage - ✔✔Done for uterine atony that causes PPH
1. One hand compresses the uterus externally throguh the abd wall
2. Other hand is inserted so that the pressure can be placed against the anterior lower
uterine segment
✔✔What is the Medical manaement of uterine atony? - ✔✔Uterotonic Agents
✔✔What are the different uterotonic agents? - ✔✔1. Oxytocin
2. Methylergonovine maleare
3. misoprostol(prostaglandin E1)
4. Dinoprostone(Prostaglandin E2)
5. 15-methyl prostaglandin F2alpha
, ✔✔What is Methylergonovine maleate? - ✔✔causes uterine contractions within several
minutes
GIVEN IM
✔✔How is 15 methyl prostaglandin F2 alpha given? - ✔✔Given IM or direct to
myometrium
✔✔How can Dinoprostone given? - ✔✔rectal suppository
✔✔What is surgical management of Uterine atony options? - ✔✔Compression sutures
sequential artery ligation
selective arterial embolization
Hysterectomy
✔✔What surgical technique has best success rates of managing Uterine atony? -
✔✔Compression Sutures
✔✔What are Compression sutures? - ✔✔B lynch or multiple squares
they will wrap around the uterus and compress it all together
✔✔B lynch suture pic - ✔✔
✔✔What complication can be seen from periurethral laceractions from pregnancy? -
✔✔urinary retention
✔✔3. Retained Placenta - ✔✔
✔✔What facilitates separation of the Placenta and uterus? - ✔✔contractrion of the
uterus
✔✔What areas are cleaved between placenta and uterus from uterine contractions? -
✔✔Cleavage of the zona basalis and the zona spongiosa
✔✔After the placenta is separated what will happen? - ✔✔expulsion through strong
uterine contractions
✔✔What can remaining placental tissue in uterus cause? - ✔✔disrupts uterine
contraction efficacy thus leading to excessive bleeding
