What is the most common cause of early postpartum hemorrhage?

Uterine atony is identified as the most common cause of early postpartum hemorrhage, which is bleeding that occurs within the first 24 hours after delivery. This condition, characterized by the failure of the uterus to contract effectively following childbirth, is fundamental because the contractions are essential for compressing the blood vessels that were previously attached to the placenta. If the uterus does not contract properly, it can lead to significant blood loss.

Contributing factors to uterine atony may include over-distended uterine muscles, multiple pregnancies, prolonged labor, or the use of certain medications during delivery. In terms of management, immediate interventions to treat uterine atony typically involve uterotonics, which promote uterine contractions, and physical methods like uterine massage.

Other potential causes of early postpartum hemorrhage, while significant, are less common than uterine atony. Genital tract trauma can lead to bleeding as well but does not occur as frequently as issues related to uterine atony. Coagulation disorders, although important to consider in evaluating bleeding etiologies in postpartum patients, are not as prevalent as uterine atony. Retained placental tissue can also cause hemorrhage, but the immediate risk of early postpartum hemorrhage is predominantly associated with the uterus