Postpartum Hemorrhage MCQ Quiz Questions And Answers

Atonic bleeding refers to excessive bleeding after childbirth due to the lack of uterine muscle tone. When the uterus fails to contract and remain firm after delivery, it cannot effectively close off the blood vessels, leading to continuous bleeding. This condition is a common cause of postpartum hemorrhage. Therefore, the statement "Atonic bleeding is due to a lack of tone in the uterus" is true.

A PPH (postpartum hemorrhage) is defined as a blood loss of more than 1000 mL after a C-section. This means that for a blood loss to be considered a PPH, it would have to be greater than 1000 mL.

All of the mentioned types of trauma during labor and birth can lead to an increased risk of postpartum hemorrhage (PPH). Instrumental assisted birth, such as the use of vacuum or forceps, can cause trauma to the birth canal and increase the likelihood of excessive bleeding. C-sections involve surgical incisions in the uterus, which can also lead to PPH. Lacerations of the cervix or vaginal wall can cause significant bleeding and contribute to the risk of PPH. Therefore, all three options can potentially result in PPH.

The correct answer is 1, 4, 6 & 8. The 4 "T's" of PPH (Postpartum Hemorrhage) are trauma, tissue, thrombin, and tone. Trauma refers to any injury or damage to the reproductive organs during childbirth. Tissue refers to retained placental tissue or blood clots in the uterus. Thrombin is a clotting factor that helps to stop bleeding. Tone refers to the contraction of the uterus after childbirth, which helps to control bleeding. Therefore, options 1, 4, 6, and 8 include all the correct "T's" of PPH.

The normal blood flow through the placental site each minute is 500-800 mls per minute. This means that during pregnancy, the placenta receives a significant amount of blood flow to support the growing fetus. This blood flow is necessary for the exchange of oxygen, nutrients, and waste products between the mother and the baby.

Early and frequent breastfeeding is actually beneficial in preventing postpartum hemorrhage. It stimulates the release of oxytocin, a hormone that causes uterine contractions, which helps to control bleeding. The other options, prolonged labor, multiple gestation (e.g., twins or triplets), and a history of postpartum hemorrhage, are all recognized risk factors for postpartum hemorrhage.

If continued bleeding occurs during the third stage of labor with a contracted uterus, the most likely cause is cervical and perineal lacerations. Lacerations in these areas can result in persistent bleeding. Other possible causes such as placental abruption, uterine atony, or cervical polyp may also cause bleeding but are less likely in this scenario.

PPH stands for postpartum hemorrhage, which refers to excessive bleeding after childbirth. In this case, the correct answer is 1 because both options 1 and 3 are possible signs of PPH. A blood loss of more than 500 mL over 24 hours is considered abnormal and can indicate PPH. Tachycardia, which is an abnormally fast heart rate, can also be a sign of PPH. Hypotension, or low blood pressure, is not specifically mentioned as a sign of PPH in this question.

Increta and percreta are both types of abnormal placental implantation where the placenta invades the uterine wall more deeply than normal. This can cause damage to blood vessels in the uterus, leading to excessive bleeding. Normal and accreta, as well as accreta and increta, do not involve the same level of invasion and are therefore less likely to cause excessive bleeding. Therefore, the correct answer is Increta & Percreta.

Uterine atony refers to the inability of the uterus to contract effectively after childbirth. This lack of contraction prevents the blood vessels at the placental site from closing properly, leading to excessive bleeding. It's the leading cause of postpartum hemorrhage, a serious condition that can occur after vaginal or cesarean delivery.