A nurse is reviewing the medical record of a client who gave birth 2 hours ago. Which of the following findings increases the client's risk for a postpartum hemorrhage?

Rationale: A. Moderate lochia rubra is incorrect because moderate vaginal bleeding is expected in the first 24 hours after birth. Lochia rubra is the normal postpartum discharge composed of blood and decidual tissue, and moderate flow does not indicate hemorrhage or increased risk. B. First degree perineal laceration is incorrect because it involves only the vaginal mucosa or perineal skin. First degree lacerations typically heal quickly and are associated with minimal blood loss, so they do not significantly increase the risk of postpartum hemorrhage. C. Bloggy uterus is correct because a soft, poorly contracted uterus (uterine atony) is the most common cause of postpartum hemorrhage. A firm, contracted uterus compresses the uterine blood vessels to prevent excessive bleeding. When the uterus is boggy, blood vessels remain open, increasing the risk for significant postpartum bleeding, which is a medical emergency if not promptly managed. D. Singleton pregnancy is incorrect because multiple gestation, not a singleton pregnancy, increases the risk of uterine overdistension and subsequent hemorrhage. A single fetus generally does not place the uterus at the same level of risk for atony as twins or higher-order multiples.