Chapter-03 Medical Management of Postpartum Hemorrhage: The Present Guidelines

BOOK TITLE: Manual of Postpartum Hemorrhage and High-Risk Pregnancy

1. Mukherji Joydev
Publishing Year
Author Affiliations
1. RG Kar Medical College, Kolkata, RG Kar Medical College Hospital, Kolkata, North Bengal Medical College, West Bengal, India, RG Kar Medical College, Kolkata, West Bengal, India, RG Kar Medical College, Kolkata, WB, India, RG Kar Medical College and Hospital, Kolkata, West Bengal, India, Kolkata, West Bengal, India, North Bengal Medical College, Siliguri, West Bengal, India
Chapter keywords
Postpartum hemorrhage, PPH, hospital specific protocol, peripartum blood loss, multidisciplinary team, estimated blood loss, EBL, monitoring


The aim of this chapter is to focus on the medical management of postpartum hemorrhage. Postpartum hemorrhage (PPH) is a rare but serious condition where a woman experiences heavy bleeding after giving birth. This chapter covers the need for hospital specific protocols, transfer to appropriate center, estimation of peripartum blood loss, multidisciplinary team, temporizing measures, management of postpartum hemorrhage, and monitoring. Almost all guidelines, recommend instituting a policy or establishing a protocol when PPH is identified, yet the specifics to the protocol vary. The visual estimation of peripartum blood loss is inaccurate and that clinical signs and symptoms should be included in the assessment of PPH. Some guidelines invoke basic measures for estimated blood loss (EBL) of 500–1,000 mL with no clinical shock and a full protocol of measures for EBL greater than 1,000 mL and continuing bleeding, or where there is evidence of clinical shock.

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