What usually causes delayed postpartum hemorrhage?

What usually causes delayed postpartum hemorrhage?

• A. Retained placental fragments
• B. Uterine atony
• C. Vaginal laceration
• D. Coagulopathy

Answer: (A)

Delayed postpartum hemorrhage is most often due to retained placental tissue. When fragments of placenta remain in the uterus after delivery, the placental bed continues to bleed as the uterus attempts to involute and heal. This ongoing bleeding typically occurs days to weeks after birth, making retained products the classic cause of delayed hemorrhage. Uterine atony, on the other hand, causes heavy bleeding right after delivery because the uterus fails to contract effectively. Vaginal lacerations produce external bleeding at the time of birth rather than a delayed postpartum hemorrhage. Coagulopathy can lead to bleeding as well, but it is not the usual cause of delayed postpartum hemorrhage. If retained products are suspected, evaluation with ultrasound is common, and treatment involves removing the tissue via suction curettage or dilation and curettage, followed by measures to promote uterine contraction and prevent infection.

Delayed postpartum hemorrhage is most often due to retained placental tissue. When fragments of placenta remain in the uterus after delivery, the placental bed continues to bleed as the uterus attempts to involute and heal. This ongoing bleeding typically occurs days to weeks after birth, making retained products the classic cause of delayed hemorrhage.

Uterine atony, on the other hand, causes heavy bleeding right after delivery because the uterus fails to contract effectively. Vaginal lacerations produce external bleeding at the time of birth rather than a delayed postpartum hemorrhage. Coagulopathy can lead to bleeding as well, but it is not the usual cause of delayed postpartum hemorrhage.

If retained products are suspected, evaluation with ultrasound is common, and treatment involves removing the tissue via suction curettage or dilation and curettage, followed by measures to promote uterine contraction and prevent infection.