American Board of Family Medicine (ABFM) Practice Exam

Following delivery, if the patient experiences bleeding due to a soft, boggy uterus, what condition is likely occurring?

1. Retained placenta

2. Uterine atony

3. Placenta previa

4. Uterine rupture

The correct answer is: Uterine atony

Uterine atony is the most likely condition occurring when a patient experiences bleeding due to a soft, boggy uterus following delivery. This condition refers to the failure of the uterus to contract effectively after childbirth, which is essential for controlling bleeding. When the uterus is firm, it can compress the blood vessels that were disrupted during the placental separation, reducing the potential for hemorrhage. However, if the uterus remains soft and boggy, it indicates that it is not contracting properly, leading to increased risk of postpartum hemorrhage. Retained placenta can contribute to uterine atony but is a separate issue where there are remnants of placental tissue that prevent the uterus from contracting fully. Placenta previa involves the placenta being located over the cervical opening, which is not typically associated with a soft uterus immediately postpartum. Uterine rupture is a more severe and typically less common condition that presents with distinct signs and is not characterized specifically by a boggy uterus. By understanding these conditions in relation to uterine atony, it becomes clear why the identification of a soft, boggy uterus is indicative of this particular complication following delivery. Managing uterine atony promptly is critical to prevent significant postpartum hemorrhage, integrating interventions that may include medication, uterine massage