A 25 year old woman with type 1 diabetes mellitus has delivered a baby weighing 4.5kg. Her uterus is well contracted. Choose the single most likely predisposing factor for PPH from the options

The key is B. Cervical/vaginal trauma. [The baby is a big baby. If patient’s uterus was not well

contracted we would fear of atonic uterus! But as uterus is well contracted it is not atonic uterus. Rather

most likely cause is trauma during delivery of this big baby].