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Gynaecology & Obstetrics
A 30 year old woman pare 6 delivers vaginally following normal labour with spontaneous delivery of an intact placenta. Excessive bleeding continues, despite manual exploration, bimanual massage, intravenous oxytocin and administration of 0.2 mg methergin IV, which one of the following would be the next step in the management of this patient :
Packing the uterus
immediate hysterectomy
Bilateral internal iliac ligation
Injection of PGF 2a
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