What is the most common cause of early postpartum hemorrhage?

Atony is recognized as the most common cause of early postpartum hemorrhage, typically occurring within the first 24 hours after delivery. Uterine atony refers to the failure of the uterus to contract effectively after childbirth, which is crucial for helping to compress the blood vessels and reduce blood loss. When the uterine muscles remain relaxed, blood vessels that were attached to the placenta can continue to bleed profusely, leading to significant postpartum hemorrhage.

This condition is often exacerbated by various factors including prolonged labor, overdistension of the uterus (as seen in cases of multiple gestations or polyhydramnios), and certain medications that may affect uterine tone. The importance of timely recognition and management of uterine atony cannot be overstated, as prompt interventions such as uterine massage, medications like oxytocin, and surgical interventions if necessary, can effectively control the bleeding and prevent severe complications for the patient.

Other causes of early postpartum hemorrhage, such as lacerations, retained placenta, and coagulation disorders, although they can contribute to bleeding, are less common than atony in the immediate postpartum period. Each of these conditions warrants consideration in the differential diagnosis of postpartum hemorrhage, but uterine atony remains the predominant