Final answer:
After ruling out retained POC, uterine atony is the next diagnosis to consider for postpartum hemorrhage. It is essential for the uterus to contract effectively to prevent hemorrhage. Breastfeeding can assist with this by promoting uterine contractions.
Step-by-step explanation:
If retained products of conception (POC) have been ruled out as a cause of postpartum hemorrhage, the next diagnosis to consider is uterine atony. Uterine atony is a failure of the uterus to contract effectively after delivery. It is the most common cause of postpartum hemorrhage. If the myometrium does not contract, the blood vessels that were attached to the placenta can continue to bleed. Additional causes for postpartum hemorrhage that may be considered if uterine atony is not present include cervical laceration, coagulopathy, and placenta accreta.
An intact placenta and fetal membranes are crucial for preventing retained POC, which can lead to hemorrhage. Breastfeeding may facilitate uterine contractions, which are necessary for involution and reducing postnatal bleeding. Additionally, the postpartum discharge lochia also indicates that the uterus is healing properly following delivery.