A 25-year-old gravida 2,para 2-0-0-2 gave birth 4 hours ago to a 9-lb,7-oz boy after augmentation of labor with oxytocin (Pitocin).She puts on her call light and asks for her nurse right away,stating "I'm bleeding a lot." The most likely cause of postpartum hemorrhage in this woman is:

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This woman gave birth to a macrosomic infant after oxytocin augmentation.The most likely cause of bleeding 4 hours after delivery,combined with these risk factors,is uterine atony.Although retained placental fragments may cause postpartum hemorrhage,this typically is detected in the first hour after delivery of the placenta and is not the most likely cause of hemorrhage in this woman.Although unrepaired vaginal lacerations may cause bleeding,they typically occur in the period immediately after birth.Puerperal infection can cause subinvolution and subsequent bleeding;however,this typically is detected after 24 hours postpartum.

A 25-Year-Old Gravida 2,para 2-0-0-2 Gave Birth 4 Hours Ago