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OBG · Postpartum haemorrhage: tamponade
Sample itemAtonic PPH continues despite oxytocin, ergometrine and carboprost. Which is the next step that is minimally invasive and preserves fertility?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Intrauterine balloon tamponade
A Bakri balloon or condom catheter tamponade, inflated with saline, tests whether bleeding stops (tamponade test). If it fails, surgical options such as B-Lynch compression suture, uterine artery ligation or hysterectomy follow. Uterine artery embolisation is another option where available.
Option by option
A. Immediate hysterectomy
Hysterectomy is a last resort.
B. Wait and observe
Observation risks death.
C. Intrauterine balloon tamponade (correct)
Correct. Balloon tamponade is a conservative step.
D. Radiotherapy
Radiotherapy has no role.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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