This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: FMGE 2019, Subject name: Gynaecology & Obstetrics
A 34 years old lady with 4 children, after 5th normal vaginal delivery, excessive bleeding occurs after placenta is removed. What is the cause for this? 
Select and explain. 
A. Estrogen, B. Progesterone, C. FSH and LH, D. PPH
D: PPH
Answer: D: PPH 
Explanation: In above case, excessive bleeding after placenta removal is due to PPH (postpaum hemorrhage) due to uterine atonicity Causes of PPH: 4 T's 1. Poor tone 2. Trauma 3. Thrombin deficiency 4. Tissues (retained)