Which of the following women is at greatest risk of developing a postpartum hemorrhage?
a. 18-year-old G1P1 with a history of gestational diabetes
b. 30-year-old G4P4 who delivered a 9 lb 7 oz baby
c. 25-year-old G2P2 who had a 12-hour labor
d. 22-year-old G1P1 with a first-degree episi-otomy
B
Cervical or perineal lacerations are a risk factor for postpartum hemorrhage. With the normal size of fetus being 6 lb 10 oz to 7 lb 15 oz, a neonate weighing 9 lb 7 oz would pose a risk for lacerations of the cervix and perineum. Gestational diabetes will not increase the risk of postpartum hemorrhage. A 12-hour labor for a 25-year-old G2P2 is within normal range. Also, a first-degree episiotomy is not a risk factor for postpartum hemorrhage.
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