What Causes Post-Partum Hemorrhage?
The most common causes include uterine atony (reduced tone of the uterus after child birth), retained placenta, abnormal attachment of the placenta to the uterus (placenta accreta, placenta previa), and lower genital tract trauma. Uterine Atony Uterine atony is the most common cause of post-partum hemorrhage and occurs when the uterus fails to contract after birth. An abnormal attachment of the placenta is the second most common cause of post-partum hemorrhage. This can be seen with placenta previa, which occurs when the placenta is found within the lowest part of the uterus and covers all or part of the cervix, or with placenta accreta, which occurs when the placenta attaches itself too deeply into the wall of the uterus. Placenta Accreta Risk Factors Risk factors for placenta accreta include placenta previa, prior myomectomy for fibroids, prior c-section, Asherman’s syndrome, submucosal fibroids, and maternal age older than 35 years. It is important to have a high degree of suspicion
