/A 30-year-old woman para 6 delivers vaginally folllowing normal labour with spontaneous delivery If an intact placenta. Excessive bleeding continues, jggpite manual exploration, bimanual massage Lravenous oxytocin and admlnls-tration of 0.2 mg Ithergin IV, which one of the following would be the next step iri the management of this patient?
This is a case of Aronuc PPH as the patient has presented with vaginal bleeding immediately after delivery and uterus is not palpable per abdominally The first step in management should be uterotonic agents If bleeding is not controlled by using uterotonic agents then PGF2alpha should be used Ref: Dutta Obs 9e pg 389.
General obstetrics
Packing the uterus
Immediate hysterectomy
Bilateral internal iliac ligation
injection of PGF 2a
injection of PGF 2a