This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Episiotomy, Subject name: Gynaecology & Obstetrics
A low risk primigravida underwent vaginal delivery with episiotomy. 2 hours after delivery patient appears pale, PR 110/min BP is 90/60 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? 
Select and explain. 
A. Blood and fluid transfusion with IV antibiotics, B. Blood transfusion and cold compression of episiotomy, C. Immediate exploration of episiotomy and blood transfusion, D. Cervical exploration with uterotonics with blood transfusion
C: Immediate exploration of episiotomy and blood transfusion
Answer: C: Immediate exploration of episiotomy and blood transfusion 
Explanation: 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.