All of the following are causes of secondary postpaum hemorrhage except:: (A) Retained cotyledon, (B) Endometritis, (C) Placental polyp, (D) Placenta pre
Answer is D. Postpaum hemorrhage (PPH) occuring in the first 24 hrs after delivery is called primary or early PPH, and placenta pre causes early/Primary PPH. It is also a primary cause of antepaum hemorrhage. Secondary postpaum hemorrhage (late PPH): It is defined as bleeding 24 hours to 12 weeks after delivery. Causes: Abnormal involution of the placental site. Retention of placental cotyledon or products of conception. Placental polyp: Retained products undergo necrosis with fibrin deposition and eventually form a placental polyp, which on detachment from the myometrium causes of brisk hemorrhage. Placenta accreta Uterine aery pseudoaneurysm Endometritis Coagulopathy Ref: Williams Obstetrics 24th edition Pgno: 670, 671