Question

What is the most common cause of tenth day (secondary) postpartum bleeding?

• A. Retained bits of membrane or placenta
• B. Infection
• C. Endometritis
• D. Blood coagulopathy

Hint:

Late postpartum bleeding usually means something was left behind in the uterus.

Answer 1

The Correct Option is A

Step 1: Bleeding on day ten falls into the secondary postpartum hemorrhage window, which runs from one day after birth up to about six weeks postpartum.

Step 2: When products of conception such as placental fragments or membranes stay behind in the uterus, the uterine cavity cannot involute fully and the placental bed keeps bleeding. This is the leading reason for late bleeding.

Step 3: Genital tract infection and endometritis usually develop on top of these retained products, so they are associated factors rather than the prime cause.

Step 4: Clotting disorders rarely present this late. So the most frequent culprit is retained membrane or placental tissue.

\[\boxed{\text{Retained bits of membrane}}\]