What type of trauma is associated with persistent vaginal bleeding post-delivery with a contracted uterus?

Persistent vaginal bleeding following delivery, particularly when accompanied by a contracted uterus, is often indicative of a genital tract laceration. These lacerations can occur during vaginal delivery due to trauma to the perineum, vagina, or cervix. A contracted uterus itself can reduce the likelihood of bleeding due to uterine atony, thus directing attention to the possibility of lacerations in the genital tract as the source of bleeding.

Genital tract lacerations may vary in severity; they can be first-degree (involving only the vaginal mucosa), second-degree (involving the vaginal mucosa and perineal muscles), or more severe third- and fourth-degree lacerations, which extend deeper. Recognizing this type of trauma is essential for timely intervention, as untreated lacerations can lead to significant morbidity due to blood loss or infection.

In contrast, uterine rupture typically presents with more dramatic symptoms, including abdominal pain, signs of shock, and a non-contracted uterus due to the disruption of the uterine wall. Placental abruption usually leads to painful vaginal bleeding and uterine rigidity rather than just persistent bleeding in the presence of a contracted uterus. Vaginal evisceration is a rare and severe complication that would present