A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but the mother has experienced postpartum hemorrhage. Which of the following disorders is most likely to underlie the client's excessive bleeding after delivery?
A) Disseminated intravascular coagulation
B) Hemophilia A
C) Von Willebrand disease
D) Thrombotic thrombocytopenic purpura (TTP)
Ans: A
Feedback:
Obstetric complications account for 50% of cases of disseminated intravascular coagulation; tissue factors released from necrotic placental or fetal tissue or amniotic fluid may enter the circulation, inciting DIC. Hemophilia A would be a central aspect of the client's medical history if it were present, and von Willebrand disease does not typically cause massive bleeding. The etiology of TTP is not normally obstetric.
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