Postpartum Care And Complications Practice Test

Patient A is a 28-year-old woman presenting for a routine postpartum visit six weeks after a vaginal delivery with a second-degree perineal laceration repaired at delivery. She reports light spotting that has turned yellow-white, no fever, and improved perineal pain. She is exclusively breastfeeding and has not resumed sexual activity. Vitals are normal. Exam: well-healed perineum, uterus involuted, no uterine tenderness. She has a history of chronic hypertension controlled with labetalol. Which of the following is the most important follow-up care consideration?

Patient A is a 32-year-old woman who delivered vaginally twenty-four hours ago and now has continued brisk bleeding despite a firm uterus after massage and oxytocin infusion. Delivery was complicated by a shoulder dystocia but no operative instruments were used. Vitals: HR 118/min, BP 94/58 mm Hg. Exam: uterus firm at the umbilicus; bright red bleeding continues; inspection shows a deep vaginal laceration with active bleeding. Labs: platelets 230,000/µL, PT/INR normal. Which of the following is the most appropriate management step?