A nurse is reviewing the medical record of a patient who had a vaginal delivery 3 hours ago. Which findings place the patient at risk for postpartum hemorrhage? (Select all that apply)

Choice A rationale
An incompetent cervix is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy. This condition is not directly related to the client’s current state of being 80% effaced and 8 cm dilated.
Choice B rationale
Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Mild cases are treated with dietary changes, rest, and antacids.
More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line. This condition is not directly related to the client’s current state of being 80% effaced and 8 cm dilated.
Choice C rationale
Postpartum hemorrhage is a condition that can occur due to a variety of factors, one of which is a rapid or prolonged labor, which can result in uterine atony. Given that the client is 80% effaced and 8 cm dilated, she is in active labor and could potentially be at risk for postpartum hemorrhage.
Choice D rationale

An ectopic pregnancy is a pregnancy in which the fertilized egg implants outside the uterus. The client is already in active labor, which means the pregnancy is not ectopic.

Choice A rationale

While it’s true that symptoms of GBS in pregnant women are often not apparent, the absence of symptoms does not eliminate the risk of transmission to the baby during delivery.
Therefore, this is not the primary reason for the timing of the test.
Choice B rationale
Even though a woman’s previous deliveries were negative for GBS, it doesn’t mean she won’t have GBS in subsequent pregnancies. GBS can come and go in a person’s body without symptoms, so even if previous tests were negative, a woman could still have GBS in her current pregnancy.
Choice C rationale
GBS is not typically part of early prenatal testing. It is usually tested for late in the third trimester because a woman can test negative earlier in pregnancy and be positive by the time of delivery.
Choice D rationale
This is the correct answer. The primary reason for testing for GBS late in pregnancy is to identify women who are GBS positive at the time of delivery, as these women have a risk of transmitting GBS to their newborns during delivery.