TY - CHAP M1 - Book, Section TI - Genital Tract Lacerations and Hematomas A1 - Yeomans, Edward R. A1 - Hoffman, Barbara L. A1 - Gilstrap III, Larry C. A1 - Cunningham, F. Gary PY - 2017 T2 - Cunningham and Gilstrap's Operative Obstetrics, 3e AB - Postpartum hemorrhage caused by trauma to the birth canal is obvious in most cases. Important exceptions are unrecognized accumulations of blood within the uterus or vagina as well as uterine rupture with intraperitoneal bleeding. Initial assessment strives to differentiate uterine atony from genital tract lacerations. An understanding of predisposing risk factors shown in Table 30-1 can aid this discrimination. It is axiomatic that persistent bleeding despite a firm, well-contracted uterus suggests that hemorrhage most likely is from lacerations. Bright red blood further suggests arterial bleeding. To confirm that lacerations are a source of bleeding, careful inspection of the vagina, cervix, and uterus is essential. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - obgyn.mhmedical.com/content.aspx?aid=1138215796 ER -