Postpartum hemorrhage is most commonly caused by which condition?

Postpartum hemorrhage is most commonly caused by which condition?

• A. Placenta previa
• B. Placental abruption
• C. Infection
• D. Uterine atony

Answer: (C)

Uterine atony, or a failure of the uterus to contract effectively after delivery, is the most common cause of postpartum hemorrhage. When the uterus contracts strongly, it compresses the blood vessels at the placental site and prevents continued bleeding. If the uterus remains flaccid, those vessels stay open and heavy bleeding ensues, leading to a postpartum hemorrhage. Factors that can predispose to atony include a uterus that is overstretched (as in multiple gestation or a large baby), prolonged or rapid labor, high parity, certain medications, and the use of magnesium sulfate. While infections and placental problems can cause bleeding, they are not the primary source of postpartum hemorrhage; the artery-clamping effect of a well-contracted uterus is what normally controls postpartum bleeding. Management focuses on restoring tone with uterotonic drugs, uterine massage, and supportive care, escalating to surgical measures if bleeding persists.

Uterine atony, or a failure of the uterus to contract effectively after delivery, is the most common cause of postpartum hemorrhage. When the uterus contracts strongly, it compresses the blood vessels at the placental site and prevents continued bleeding. If the uterus remains flaccid, those vessels stay open and heavy bleeding ensues, leading to a postpartum hemorrhage. Factors that can predispose to atony include a uterus that is overstretched (as in multiple gestation or a large baby), prolonged or rapid labor, high parity, certain medications, and the use of magnesium sulfate. While infections and placental problems can cause bleeding, they are not the primary source of postpartum hemorrhage; the artery-clamping effect of a well-contracted uterus is what normally controls postpartum bleeding. Management focuses on restoring tone with uterotonic drugs, uterine massage, and supportive care, escalating to surgical measures if bleeding persists.