A 26-year-old woman, gravida 2, para 2, aborta 0, has just delivered a full-term newborn...

Comprehensive and Detailed Explanation:

In postpartum hemorrhage with a firm uterine fundus and intact placenta, a common cause is trauma such as a vaginal or cervical tear. Uterine atony (A) typically presents with a boggy uterus. The absence of systemic instability or coagulopathy makes options D and E less likely.

Toronto Notes 2023 – Obstetrics, Postpartum Hemorrhage:

“Continued bleeding despite a firm fundus and intact placenta should raise suspicion for genital tract trauma, especially cervical or vaginal lacerations.”

MCCQE1 Objectives – Obstetrics > Postpartum Complications:

“Candidates must differentiate causes of postpartum hemorrhage and identify when bleeding is due to trauma vs uterine atony.”

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