<prompt> A low risk primigravida underwent vaginal delivery with episiotomy. 2 hours after delivery patient appears pale, PR 110min BP is 9060 but there is no apparent PPH. PV examination shows a bulge over episiotomy stitch line. Hb shows a drop in Hb from 9 gm to 7 gm. Management is?Blood and fluid transfusion with IV antibioticsBlood transfusion and cold compression of episiotomyImmediate exploration of episiotomy and blood transfusionCervical exploration with uterotonics with blood transfusion  <response>: The patient is showing signs of hemodynamic compromise with a significant drop in hemoglobin. This is suggestive of acute haemorrhage. As uterine bleeding is not evident and a bulge is present at site of episiotomy, it appears to be a case of a large hematoma at episiotomy which should be urgently explored, evacuated and bleeder should besecured. 