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Gynaecology & Obstetrics Obstetrics b99752e5

A patient underwent LSCS for arrest of second stage of labour. A lateral extension of an angle of uterine incision occurred during delivery of head which was secured. Post operatively after 2 hours patient develops pallor, abdominal distension with tachycardia. Hb dropped from 10 gm% (pre op) to 6.5 gm%. Pelvic exam revealed mild PPH. Next step in management is?

A
Uterotonics for control of PPH and blood transfusion
B
Blood transfusion and monitoring
C
Immediate exploration in OT
D
Intrauterine packing and blood transfusion
High-Yield Explanation
Patient here is showing signs of hemodynamic compromise post LSCS which had a lateral extension and a drop in hemoglobin suggestive of acute hemorrhage. Mild PPH does not correspond with the amount of compromise and anemia. Therefore it appears to be a case of intraabdominal bleeding from lateral extension or an unidentified bleeder, which should be immediately explored and secured.

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