Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture.
As well as cervical insufficiency defined as a midtrimester (14th-26th week) dilation of the cervix which may need medical intervention to assist in keeping the pregnancy sustainable.
[10] Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding.
Other definitions of excessive postpartum bleeding are hemodynamic instability, drop of hemoglobin of more than 10%,[12] or requiring blood transfusion.
This pathology occurs due to the normal physiological drop in maternal clotting factors after delivery which greatly increases the risk of secondary postpartum hemorrhage.
[14] Another bleeding risk factor is thrombocytopenia, or decreased platelet levels, which is the most common hematological change associated with pregnancy induced hypertension.