Differential Diagnosis for Postpartum Hemorrhage (PPH)
Single Most Likely Diagnosis
- Retained placenta: This is the most likely cause of heavy bleeding after delivery, especially if the placenta has not been fully expelled or if there are any issues with placental separation. Retained placenta can lead to significant bleeding and is a common cause of postpartum hemorrhage.
Other Likely Diagnoses
- Uterine atony: This is a condition where the uterus fails to contract down effectively after delivery, leading to excessive bleeding. Uterine atony is a common cause of postpartum hemorrhage, especially in women who have had multiple pregnancies or deliveries.
- Previous multiparity: While not a direct cause of bleeding, previous multiparity can increase the risk of uterine atony and other complications that may lead to postpartum hemorrhage.
- Big baby (macrosomia): Delivering a large baby can increase the risk of postpartum hemorrhage due to the increased risk of uterine atony and potential trauma to the uterus during delivery.
Do Not Miss Diagnoses
- Placenta accreta: This is a condition where the placenta grows too deeply into the uterine wall, leading to severe bleeding during delivery. Placenta accreta is a life-threatening condition that requires prompt diagnosis and treatment.
- Uterine rupture: This is a rare but life-threatening condition where the uterus tears during delivery, leading to severe bleeding and potentially catastrophic consequences.
Rare Diagnoses
- Coagulopathy: This is a condition where the blood's ability to clot is impaired, leading to excessive bleeding. Coagulopathy can be caused by various factors, including genetic disorders, liver disease, or certain medications.
- Invasive placenta: This is a condition where the placenta invades the uterine wall or other surrounding tissues, leading to severe bleeding during delivery. Invasive placenta is a rare but potentially life-threatening condition that requires prompt diagnosis and treatment.