Maternity Nursing: Postpartum Q 26

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Which of the following complications may be indicated by continuous seepage of blood from the vagina of a PP client, when palpation of the uterus reveals a firm uterus 1 cm below the umbilicus?

  

     A. Uterine atony

     B. Cervical laceration

     C. Urinary tract infection

     D. Retained placental fragments

    

    

Correct Answer: B. Cervical laceration

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Continuous seepage of blood may be due to cervical or vaginal lacerations if the uterus is firm and contracting. Cervical lacerations (CL) are a known cause of postpartum hemorrhage. Although CL occurs in more than half of vaginal deliveries,1 they are less than 0.5 cm in length and rarely require repair.

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Option A: Uterine atony may cause subinvolution of the uterus, making it soft, boggy, and larger than expected. Atony of the uterus, also called uterine atony, is a serious condition that can occur after childbirth. It occurs when the uterus fails to contract after the delivery of the baby, and it can lead to a potentially life-threatening condition known as postpartum hemorrhage.

Option C: UTI won’t cause vaginal bleeding, although hematuria may be present. Urinary tract infection (UTI) is a common postpartum infection occurring in 2%–4% of all deliveries. Although postpartum UTI is usually a mild infection, it is associated with discomfort, prolonged hospital stay and readmission and has been associated with an increased risk of discontinued breastfeeding.

Option D: Postpartum retained placental fragments (RPF) are most often clinically manifested as delayed postpartum hemorrhage or prolonged postpartum spotting. This is a rare complication of labor, yet can potentially cause severe morbidity and discomfort.

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