Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is a complication frequently encountered following delivery. The major issues related to PPH are mortality and long term morbidity. It is one of the leading causes of maternal mortality around the world, especially in developing countries. It is responsible for 20-30% of maternal death, and a majority of which occurs within 4 h of post-delivery [1]. Postpartum hemorrhage (PPH) is continued to be the leading preventable cause of maternal morbidity and mortality, worldwide. The diagnostic criteria differ according to the society, classically defined as blood loss of 500 ml or more for vaginal delivery and 1000ml or more for cesarean delivery. It is considered as primary or secondary depending upon occurrence time from delivery (before or after 24 hours). The causes can be summarized by four “T”s - Tone, Tissue, Trauma and Thrombin. Since, it is a significant cause for maternal death, steps to promptly identify the patients who are at risk of PPH (Predict), routine active management of 3rd stage of labor, (Prevent) and appropriate monitoring and management of post-partum hemorrhage is of utmost importantce. Millennium Development Goal (MDG) 2030 is to reduce the maternal mortality ratio to 70, and prevention and management of PPH is a key step toward it.