Which postpartum symptom would require urgent evaluation after discharge?

• A. Fever.
• B. Severe headache with visual changes.
• C. Chest pain.
• D. Heavy vaginal bleeding with saturating more than one pad per hour.

Answer: (D)

Heavy vaginal bleeding that saturates more than one pad per hour signals postpartum hemorrhage, the most time-sensitive danger after discharge. When the uterus isn’t contracting well or there’s retained placental tissue or a birth-related injury, blood loss can escalate quickly and lead to hypovolemia or shock. Recognizing this pattern prompts urgent evaluation to assess uterine tone, stabilize the patient, and initiate treatment such as uterotonics, fluids, and possible transfusion. Other symptoms like fever, severe headache with vision changes, or chest pain are serious and require prompt care as well, but the rapid progression and potential for life-threatening blood loss make heavy bleeding the most urgent red flag postpartum.