What maternal condition is associated with an increased risk for postpartum hemorrhage?

Multiple pregnancies are associated with an increased risk for postpartum hemorrhage due to several factors. In the case of twins or higher-order multiples, the uterus becomes overstretched during pregnancy. This can lead to a less effective uterine contraction after delivery, which is crucial for controlling bleeding. If the uterus cannot contract effectively, it increases the likelihood of excessive bleeding from the placental site.

In addition to uterine overstretching, multiple pregnancies often involve other complications such as a higher incidence of previa or placental abruption, both of which can contribute to the risk of postpartum hemorrhage. Therefore, the combination of these factors makes multiple pregnancies a significant concern regarding postpartum hemorrhage.

While preexisting hypertension and preeclampsia can lead to complications during pregnancy and delivery, they are not directly correlated with the same risk level of postpartum hemorrhage as seen in multiple pregnancies. Gestational diabetes primarily affects glucose metabolism and does not typically contribute to an increased risk for hemorrhage postpartum.