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39545 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 :

APacking the uterus
Bimmediate hysterectomy
CBilateral internal iliac ligation
DInjection of PGF 2a
Gynaecology & Obstetrics
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