A postpartum patient with signs of hypotension and tachycardia after cesarean birth needs urgent evaluation for which condition?

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Significant blood loss after delivery leads to reduced circulating volume, so the body's first response is to become tachycardic to maintain perfusion, and blood pressure falls as volume drops. After a cesarean birth, the uterus has been surgically opened, which increases the risk of bleeding from the surgical site, uterine atony, retained tissue, or lacerations. When you see hypotension and tachycardia in the immediate postpartum period, the urgent concern is postpartum hemorrhage or internal bleeding. The priority is rapid assessment and intervention to stop the bleed and restore volume, including checking the uterus for tone and bleeding, establishing IV access for fluids or blood, and preparing to administer uterotonic agents to contract the uterus and, if needed, escalate to more definitive measures. Other conditions described don’t typically present with this combination of hemodynamic instability in the postpartum mother.