Which of the following lists represents risk factors that increase postpartum hemorrhage risk?

• A. Placenta previa.
• B. Retained placenta and prolonged labor only.
• C. Uterine overdistension; prolonged labor; augmentation/induction; retained placenta; placenta previa or accreta; multiple gestation; prior PPH.
• D. Prior PPH.

Answer: (C)

The risk for postpartum hemorrhage comes from several interconnected pathways: the uterus being overdistended or overstimulated by long labor, the use of interventions like induction or augmentation, problems with placental separation or attachment, and a history of bleeding in a previous birth. The best choice includes all of these factors—uterine overdistension; prolonged labor; augmentation/induction; retained placenta; placenta previa or placenta accreta; multiple gestation; and prior PPH—because it captures the major categories that raise PPH risk: uterine factors, placental factors, labor-management factors, and prior obstetric history.

Other options miss key risk factors. Placenta previa alone doesn’t cover the other important contributors; retained placenta with prolonged labor misses the labor-management and placental-attachment aspects; prior PPH alone misses the broader range of risk factors.