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NCLEX · General

What is the most common cause of maternal mortality in the United States in the postpartum period?

Correct answer

Hemorrhage — postpartum hemorrhage (blood loss exceeding 1,000 mL within 24 hours after delivery) is a leading cause of maternal morbidity and mortality; it is largely preventable with active management of the third stage of labor

  1. A Infection
  2. B Hemorrhage — postpartum hemorrhage (blood loss exceeding 1,000 mL within 24 hours after delivery) is a leading cause of maternal morbidity and mortality; it is largely preventable with active management of the third stage of labor
  3. C Preeclampsia
  4. D Pulmonary embolism

Why this is the answer

POSTPARTUM HEMORRHAGE (PPH) DEFINITION: Blood loss ≥1,000 mL (or any amount with signs of hypovolemia) within 24 hours of delivery. LEADING CAUSES — the 4 Ts: TONE (uterine atony — most common; 70-80% of PPH); TRAUMA (lacerations, uterine rupture, hematoma); TISSUE (retained placenta/products of conception); THROMBIN (coagulopathy). RISK FACTORS: Multiple gestation, uterine over-distension, prolonged labor, prior PPH, placenta previa. PREVENTION: Active Management of Third Stage of Labor (AMTSL) — uterotonic medication (oxytocin) after delivery, controlled cord traction, uterine massage. NURSING ASSESSMENT: Fundal firmness every 15 minutes in recovery; pad count; vital signs; skin perfusion. TREATMENT: Uterine massage; uterotonics (oxytocin, misoprostol, carboprost); bimanual compression; transfusion if needed; surgical intervention for refractory cases.
Source: NCLEX-RN Test Plan: Health Promotion — Postpartum, Hemorrhage

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