Obstetric Emergency practice

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Tune this setClinical rotations · Middle twist · 10 questionschange
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Obstetrics and Gynaecologymiddle twist

Immediately after delivery, a woman becomes pale and hypotensive and reports severe pelvic pain. A smooth, dark-red mass is visible at the introitus; the placenta is attached to it and the uterine fundus cannot be felt abdominally. The midwife has stopped oxytocin and called for assistance. Which one of the following should be undertaken first?