In One patient with G11 p8 with no previous anc having h/o bleeding since 2 days came in my clinic. She was in early labour head high up os one finger loose. No active bleeding at present her routine inv hb%, Hbsag, HIV blood sugar normal. In USG there was marginal placenta praevia. After one hour she delivered an alive term male baby and postpartum hemorrhage (PPH) occurred there was no clot formation of blood coming from the vagina. Uterine was well contracted.
I did manual exploration. No bits came out I did tight vaginal packing but all in vain. I gave methylergonovine, carboprost, misoprostol p/r. But ultimately I referred the patient as the patient attendant was not ready to bring blood. I think there was some blood coagulopathy give me your opinions.
