What is the most common underlying cause of early postpartum hemorrhage?

Early postpartum hemorrhage, defined as significant bleeding within the first 24 hours after delivery, is most commonly attributed to uterine atony. This condition occurs when the uterus fails to contract effectively following delivery, leading to inadequate muscle tone that allows for continued bleeding from the placental site. Factors contributing to uterine atony can include prolonged labor, overdistension of the uterus (as seen with multiple gestations or large babies), or certain medications that may impair uterine contractions.

Understanding the prevalence of uterine atony as the primary cause of early postpartum hemorrhage is essential because it guides clinical management. Immediate interventions often focus on uterine massage and medications such as oxytocin to promote uterine contraction and reduce bleeding risk. In contrast, while the other options like genital tract trauma, coagulation disorders, and retained placental tissue can cause postpartum hemorrhage, they are less common than uterine atony in the early postpartum period. This knowledge is crucial for healthcare providers to effectively identify and treat the most frequent causes of postpartum complications.