Differential Diagnosis for Postpartum Hemorrhage (PPH)
Single most likely diagnosis
- Uterine atony: This is the most common cause of postpartum hemorrhage, especially in a patient who has had a prior uterine surgery such as a low transverse cesarean section. Uterine atony occurs when the uterus fails to contract down effectively after delivery, leading to excessive bleeding.
Other Likely diagnoses
- Uterine rupture: Although less likely than uterine atony, uterine rupture is a possible cause of PPH, especially in a patient with a prior uterine scar from a cesarean section. However, the fact that the patient delivered vaginally this time does not strongly suggest rupture as the primary cause of bleeding.
Do Not Miss diagnoses
- Uterine inversion: This is a life-threatening condition that can cause severe hemorrhage. Uterine inversion occurs when the uterus turns inside out, either partially or completely, and can be associated with significant bleeding. It is crucial to consider this diagnosis in any case of PPH, as prompt recognition and treatment are essential to prevent severe morbidity and mortality.
Rare diagnoses
- Other rare causes of PPH, such as retained placental tissue, lacerations, or coagulopathy, are less likely given the information provided but should be considered in the differential diagnosis if the more common causes are ruled out. However, for the purpose of this question and the provided options, these are not listed as choices.