USMLE Question: Clinical Case

USMLE Question: Clinical Case - 14

A 24 year old female presented at term for delivery of her first baby. Her pregnancy was normal and uncomplicated throughout the course. Her medical and surgical histories didn’t reveal any remarkable event. She delivered normal healthy baby. The mode of delivery was vaginal and the placental cotyledons were complete and intact. Although her delivery was augmented by oxytocin. Five and half hour later she notices heavy vaginal bleeding and also starts complaining of severe pelvic pain.
On examination her respiratory system was normal except mild tachypnea. The abdomen was soft but tender at hypogastrium. Uterine fundus is not palpable. Pelvic examination reveals heavy fresh bleeding and 6 x 9 cm mass inside the vaginal vault. Significant vaginal and cervical tears are not noted on pelvic examination.
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