The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?

Weeks, A

doi:10.1111/1471-0528.13098

Cited by 194Maternal and fetal healthcareMaternal and Perinatal Health InterventionsBlood transfusion and management

The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?

Weeks, A·2015·BJOG: An International Journal of Obstetrics & Gynaecology

DOI 10.1111/1471-0528.13098

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Abstract

Postpartum haemorrhage (PPH) remains a major cause of maternal deaths worldwide, and is estimated to cause the death of a woman every 10 minutes. This review presents the latest clinical advice, including new evidence on controlled cord traction, misoprostol, and oxytocin. The controversy around the diagnosis of PPH, the limitations of universal prophylaxis, and novel ways to provide obstetric first aid are also presented. It ends with a call to develop high‐quality front‐line obstetric services that can deal rapidly with unexpected haemorrhages as well as minimising blood loss at critical times: major abruption, placenta praevia, and caesarean for prolonged labour.

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Oxytocin given at much higher doses to prevent post-partum haemorrhage appears to act not by oxytocin receptors but by V1a receptors on the uterine artery.
“Oxytocin is given at much higher doses to prevent post‐partum haemorrhage 59, but this action appears to be mediated not by oxytocin receptors but by V1a receptors on the uterine artery 60.”
From Measuring Oxytocin and Vasopressin: Bioassays, Immunoassays and Random Numbers (2016) · cites this paper as [59]

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Background
Vacuum-Induced Tamponade for Treatment of Postpartum Hemorrhage
Haslinger, C., Weber, K., & Zimmermann, R. (2021) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000004510 · Cited by 36 · see citing works
Hemorragia masiva obstétrica: enfoque terapéutico actual
Guasch, E., & Gilsanz, F. (2016) · Medicina Intensiva · doi:10.1016/j.medin.2016.02.010 · Cited by 34 · see citing works
Fibrinolysis Inhibitors: Potential Drugs for the Treatment and Prevention of Bleeding
Steinmetzer, T., Pilgram, O., Wenzel, B. M., & Wiedemeyer, S. J. A. (2019) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.9b01060 · Cited by 33 · see citing works
Uterine artery embolization versus hysterectomy in the treatment of refractory postpartum hemorrhage: a systematic review and meta-analysis
Liu, Z., Wang, Y., Yan, J., Li, J., Liu, X., Zhang, L., & Li, C. (2018) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2018.1497599 · Cited by 32 · see citing works
How to improve the quality of care for women with postpartum haemorrhage at Onandjokwe Hospital, Namibia: quality improvement study
Nsangamay, T., & Mash, R. J. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2635-6 · Cited by 33 · see citing works
Risk factors for postpartum haemorrhage in the Northern Province of Rwanda: A case control study
Bazirete, O., Nzayirambaho, M., Umubyeyi, A., Karangwa, I., & Evans, M. K. (2022) · PLoS ONE · doi:10.1371/journal.pone.0263731 · Cited by 32 · see citing works
Comparison of the effects and side effects of misoprostol and oxytocin in the postpartum period: A systematic review
Bilgin, Z., & Kömürcü, N. (2019) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2019.09.004 · Cited by 30 · see citing works
The role of nanoscale structures in the development of topical hemostatic agents
Mohamed, E., Fitzgerald, A., & Tsuzuki, T. (2021) · Materials Today Nano · doi:10.1016/j.mtnano.2021.100137 · Cited by 30 · see citing works
Massive obstetric hemorrhage: Current approach to management
Guasch, E., & Gilsanz, F. (2016) · Medicina Intensiva (English Edition) · doi:10.1016/j.medine.2016.02.003 · Cited by 30 · see citing works
Safety, Tolerability and Pharmacokinetics of Single Doses of Oxytocin Administered via an Inhaled Route in Healthy Females: Randomized, Single-blind, Phase 1 Study
Fernando, D., Siederer, S. K., Singh, S., Schneider, I., Gupta, A. K., Powell, M., Richards, D. B., McIntosh, M. P., Lambert, P., & Fowles, S. E. (2017) · EBioMedicine · doi:10.1016/j.ebiom.2017.07.020 · Cited by 30 · see citing works
“Following delivery, themother is, however, at risk of postpartum hemorrhage (PPH), defined as blood loss of ≥500 mL within 24 h after birth (World Health Organization, 2012), most commonly due to uterine atony (Weeks, 2015).”
BackgroundInfluential
Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives
Bazirete, O., Nzayirambaho, M., Umubyeyi, A., Uwimana, M. C., & Evans, M. K. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-03389-7 · Cited by 31 · see citing works
Efficacy of misoprostol for the treatment of postpartum hemorrhage: current knowledge and implications for health care planning
Prata, N., & Weidert, K. (2016) · International Journal of Women s Health · doi:10.2147/ijwh.s89315 · Cited by 27 · see citing works
“19,20 As early as 2007, researchers were supporting the use of misoprostol for treating PPH in cases where other treatments are not available or not working, yet treating PPH in the community with misoprostol has lagged behind its widespread prophylactic use.”
Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review
Moleiro, M. L., Braga, J. S., Machado, M. J., & Guedes‐Martins, L. (2020) · Acta Médica Portuguesa · doi:10.20344/amp.11987 · Cited by 25 · see citing works
Whole blood for postpartum hemorrhage: early experience at two institutions
Morris, D. S., Braverman, M. A., Corean, J., Myers, J. C., Xenakis, E. M.-J., Ireland, K. E., Greebon, L. J., Ilstrup, S. J., & Jenkins, D. H. (2020) · Transfusion · doi:10.1111/trf.15731 · Cited by 25 · see citing works
Risk of postpartum haemorrhage is associated with ethnicity: A cohort study of 981 801 births in England
Jardine, J. E., Gurol‐Urganci, I., Harris, T., Hawdon, J. M., Pasupathy, D., van der Meulen, J., Walker, K., & the NMPA Project Team (2021) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17051 · Cited by 25 · see citing works
Third stage of labor: evidence-based practice for prevention of adverse maternal and neonatal outcomes
Hersh, A. R., Carroli, G., Hofmeyr, G. J., Garg, B., Gülmezoglu, M., Lumbiganon, P., Mucio, B. D., Saleem, S., Festin, M., Mittal, S., et al. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.11.1298 · Cited by 25 · see citing works
Risk factors during pregnancy and birth‐related complications in HIV ‐positive versus HIV ‐negative women in Denmark, 2002–2014
Ørbæk, M., Thorsteinsson, K., Larsen, E. M., Katzenstein, T. L., Storgaard, M., Johansen, I. S., Pedersen, G. F., Bach, D., Helleberg, M., Weis, N. M., et al. (2019) · HIV Medicine · doi:10.1111/hiv.12798 · Cited by 23 · see citing works
Maternal–fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India
Keepanasseril, A., Gupta, A., Ramesh, D., Kothandaraman, K., Suriya, J. Y., & Maurya, D. K. (2020) · Hepatology International · doi:10.1007/s12072-020-10067-5 · Cited by 22 · see citing works
Impact of Recurrent Miscarriage on Maternal Outcomes in Subsequent Pregnancy: The Mutaba’ah Study
Ali, N., Elbarazi, I., Ghazal‐Aswad, S., Al‐Maskari, F., Al‐Rifai, R. H., Oulhaj, A., Loney, T., & Ahmed, L. A. (2020) · International Journal of Women s Health · doi:10.2147/ijwh.s264229 · Cited by 23 · see citing works
Assessment of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: A Cross-Sectional Study
Mesfin, S., Dheresa, M., Fage, S. G., & Tura, A. K. (2021) · International Journal of Women s Health · doi:10.2147/ijwh.s300143 · Cited by 21 · see citing works
Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
Berg, K. M., Bray, J., Djärv, T., Drennan, I. R., Greif, R. T., Liley, H. G., Scholefield, B. R., Atkins, D. L., Carlson, J. N., de Caen, A. R., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001361 · Cited by 20 · see citing works
Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015-063, August 2022)
Schlembach, D., Annecke, T., Girard, T., Helmer, H., Kainer, F., Kehl, S., Korte, W. C., Kühnert, M., Lier, H., Mader, S., et al. (2023) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-2073-9615 · Cited by 20 · see citing works
Excessive bleeding is a normal cleansing process: a qualitative study of postpartum haemorrhage among rural Uganda women
Ononge, S., Okello, E. S., & Mirembe, F. M. (2016) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-016-1014-9 · Cited by 20 · see citing works
Midwives’ challenges in the management of postpartum haemorrhage at rural PHC facilities of Limpopo province, South Africa: an explorative study
Ramavhoya, T. I., Maputle, M. S., Lebese, R. T., & Makhado, L. (2021) · African Health Sciences · doi:10.4314/ahs.v21i1.40 · Cited by 20 · see citing works
Incidence and predictors of severe postpartum hemorrhage after cesarean delivery in South Central Ethiopia: a retrospective cohort study
Zewdu, D., & Tantu, T. (2023) · Scientific Reports · doi:10.1038/s41598-023-30839-x · Cited by 19 · see citing works
First report of using low‐titer cold‐stored type O whole blood in massive postpartum hemorrhage
Bahr, T. M., DuPont, T. L., Morris, D. S., Pierson, S. E., Esplin, M. S., Brown, S. M., O’Brien, E. A., Ilstrup, S. J., & Christensen, R. D. (2019) · Transfusion · doi:10.1111/trf.15492 · Cited by 19 · see citing works
Use of a Visual Aid in addition to a Collector Bag to Evaluate Postpartum Blood loss: A Prospective Simulation Study
Brooks, M., Legendre, G., Brun, S., Bouet, P., Mendes, L. P., Merlot, B., & Sentilhes, L. (2017) · Scientific Reports · doi:10.1038/srep46333 · Cited by 19 · see citing works
Prophylactic Effect of Tranexamic Acid on Hemorrhage During and After the Cesarean Section
Milani, F., Haryalchi, K., Sharami, S. H., Atrkar-Roshan, Z., & Farzadi, S. (2018) · International Journal of Women s Health and Reproduction Sciences · doi:10.15296/ijwhr.2019.12 · Cited by 17 · see citing works
Predictors of supplementation for breastfed babies in a Baby-Friendly hospital
Kalmakoff, S., Gray, A. R., & Baddock, S. A. (2017) · Women and Birth · doi:10.1016/j.wombi.2017.08.131 · Cited by 17 · see citing works
Obstetric Hemorrhage Outcomes by Intrapartum Risk Stratification at a Single Tertiary Care Center
Hussain, S. A., Guarini, C. B., Blosser, C., & Poole, A. (2019) · Cureus · doi:10.7759/cureus.6456 · Cited by 17 · see citing works
Women in low- and middle-income countries receive antenatal care at health institutions, yet not delivered there: a multilevel analysis of 2016–2021 DHS data
Merid, M. W., Chilot, D., Yigzaw, Z. A., Melesse, A. W., Ferede, M. G., Aragaw, F. M., & Bitew, D. A. (2024) · Tropical Medicine and Health · doi:10.1186/s41182-023-00561-5 · Cited by 16 · see citing works
Is the increase in postpartum hemorrhage after vaginal birth because of altered clinical practice?: A register‐based cohort study
Graugaard, H. L., & Maimburg, R. D. (2021) · Birth · doi:10.1111/birt.12543 · Cited by 16 · see citing works
Evaluation by Obstetric Care Providers of Simulated Postpartum Blood Loss using a Collector Bag: A French prospective study.
Legendre, G., Richard, M., Brun, S., Chancerel, M., Matuszewski, S., & Sentilhes, L. (2016) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2016.1139569 · Cited by 16 · see citing works
Monitoring postpartum haemorrhage in Australia: Opportunities to improve reporting
Flood, M. M., Pollock, W., McDonald, S., & Davey, M. (2017) · Women and Birth · doi:10.1016/j.wombi.2017.07.012 · Cited by 15 · see citing works
Benefits of Screen-Based Postpartum Hemorrhage Simulation on Nontechnical Skills Training
Michelet, D., Barré, J., Job, A., Truchot, J., Cabon, P., Delgoulet, C., & Tesnière, A. (2019) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000395 · Cited by 15 · see citing works
Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature
Bazirete, O., Nzayirambaho, M., Uwimana, M. C., Umubyeyi, A., & Evans, M. K. (2020) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v11n1p66 · Cited by 13 · see citing works
Major obstetric haemorrhage: Incidence, management and quality of care in Irish maternity units
Greene, R. A., McKernan, J., Manning, E., Corcoran, P. E., Byrne, B., Cooley, S. M., Daly, D., Fallon, A., Higgins, M., Jones, C., et al. (2020) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2020.12.021 · Cited by 14 · see citing works
Healthcare providers experiences of using uterine balloon tamponade (UBT) devices for the treatment of post-partum haemorrhage: A meta-synthesis of qualitative studies
Finlayson, K. W., Vogel, J. P., Althabe, F., Widmer, M., & Oladapo, O. T. (2021) · PLoS ONE · doi:10.1371/journal.pone.0248656 · Cited by 14 · see citing works
Cost-effectiveness of uterine balloon tamponade devices in managing atonic post-partum hemorrhage at public health facilities in India
Joshi, B. N., Shetty, S. S., Moray, K. V., Sachin, O., & Chaurasia, H. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256271 · Cited by 12 · see citing works
Health care providers’ knowledge of clinical protocols for postpartum hemorrhage care in Kenya: a cross-sectional study
Henry, J., Clarke‐Deelder, E., Han, D., Miller, N., Opondo, K., Oguttu, M., Burke, T. F., Cohen, J. L., & McConnell, M. A. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05128-6 · Cited by 11 · see citing works
Amamentação na primeira hora de vida em uma instituição com iniciativa hospital amigo da criança/ Breastfeeding in the first hour of life at an institution with the baby-friendly hospital initiative
Netto, A. F. N., Spohr, F. A., Zilly, A., França, A. F. O., Rocha-Brischiliari, S. C., & da Silva, R. M. M. (2016) · Ciência Cuidado e Saúde · doi:10.4025/cienccuidsaude.v15i3.31508 · Cited by 11 · see citing works
Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China
Wu, S., He, D., & Zhang, W. (2018) · Chinese Medical Journal · doi:10.4103/0366-6999.229897 · Cited by 11 · see citing works
“Previous research has indicated that PPH results from an atonic uterus, in which the loss of myometrial tone allows maternal blood flow to the placental bed (500 ml/min during pregnancy) to continue unchecked.[18] Oxytocin enhances uterine contractions through its receptor in the uterus and is therefore responsible fo…”
Background
A Uterus-Preserving Treatment for Uncontrollable Postpartum Hemorrhage
Esike, C. O. U. (2020) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000003947 · Cited by 11 · see citing works
Extravasating uterine pseudoaneurysm: A rare cause of postpartum haemorrhage
Yi, S. W. (2017) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2016.1274292 · Cited by 11 · see citing works
“The majority of PPH cases are thought to result from an atonic uterus, in which the loss of myometrial tone allows maternal blood flow to the placental tissue; tears of the uterus, cervix or vagina; and clotting disorders (the ‘4Ts’ mnemonic: tone, tissue, trauma, and thrombin) (Weeks 2015).”
Background
Developing and prioritising strategies to improve the implementation of maternal healthcare guidelines in South Africa: The nominal group technique
Ramavhoya, T. I., Maputle, M. S., & Lebese, R. T. (2022) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v14i1.3184 · Cited by 10 · see citing works
Features of Postpartum Hemorrhage-Associated Thrombotic Microangiopathy and Role of Short-Term Complement Inhibition
Kaufeld, J. K., Kühne, L., Schönermarck, U., Bräsen, J. H., von Kaisenberg, C., Beck, B. B., Erger, F., Bergmann, C., von Bergwelt‐Baildon, A., Brinkkötter, P. T., et al. (2024) · Kidney International Reports · doi:10.1016/j.ekir.2024.01.035 · Cited by 10 · see citing works
“16,17 In rare cases, PPH may not be straightforwardly recognized as a cause of TMA because it may also cause disseminated intravascular coagulation leading to thrombocytopenia.”
Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section
Songthamwat, S., & Songthamwat, M. (2018) · International Journal of Women s Health · doi:10.2147/ijwh.s170460 · Cited by 10 · see citing works
Non-clinical interventions to prevent postpartum haemorrhage and improve its management: A systematic review
Gaucher, L., Occelli, P., Deneux‐Tharaux, C., Colin, C., Gaucherand, P., Touzet, S., & Dupont, C. (2019) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2019.07.018 · Cited by 9 · see citing works
Prenatal hypertension as the risk of eclampsia, HELLP syndrome, and critical obstetric hemorrhage
Akaishi, T., Tarasawa, K., Hamada, H., Iwama, N., Tomita, H., Akaishi, M., Fushimi, K., Fujimori, K., Yaegashi, N., & Saito, M. (2023) · Hypertension Research · doi:10.1038/s41440-023-01511-8 · Cited by 10 · see citing works
Digital postpartum hemorrhage management device (DPHMD)
Tekela, D. D., Asmare, A. G., Gebremariam, B. M., Assegahegn, C. A., Wami, K. D., Nemomssa, H. D., & Simegn, G. L. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2601-3 · Cited by 9 · see citing works
Factor XIII in the Acute Care Setting and Its Relevance in Obstetric Bleeding
Duque, P., & Korte, W. C. (2022) · Transfusion Medicine and Hemotherapy · doi:10.1159/000526489 · Cited by 8 · see citing works
“However, PPH can often occur without identifiable risk factors [48] which emphasizes the need of timely diagnosis (involving FXIII determination) and a multidisciplinary (surgical and hemostatic) treatment approach [49].”
Background
Student midwives’ knowledge, skills and competency in relation to the active management of the third stage of labour: A correlational study
Muzeya, F., & Julie, H. (2020) · Curationis · doi:10.4102/curationis.v43i1.2054 · Cited by 8 · see citing works
“However, both types of postpartum haemorrhage can be prevented by ensuring that (1) pregnant women receive good antenatal care, (2) the third stage of labour is actively managed and (3) all retained products of conception are removed (Baldvinsdottir, Blomberg & Lilliecreutz 2018:2; Weeks 2014:202).”
Background
Stillbirths and neonatal deaths among 18 942 women with postpartum hemorrhage: Analysis of perinatal outcomes in the WOMAN trial
Hough, A., Shakur‐Still, H., Roberts, I., Koukounari, A., Lawn, J. E., & Collaborators, T. W. T. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13413 · Cited by 8 · see citing works
Animal models of postpartum hemorrhage
Hargett, S. E., Leslie, E. F., Chapa, H. O., & Gaharwar, A. K. (2024) · Lab Animal · doi:10.1038/s41684-024-01349-8 · Cited by 7 · see citing works
“Furthermore, some studies claim that the prevalence of PPH is increasing in high-income countries and assert that this increase is due to more frequent interventions in obstetric patients 2,9,16,17 .”
Critical role of V1a vasopressin receptor in murine parturition†
Tsuchiya, H., Fujimura, S., Fujiwara, Y., & Koshimizu, T. (2019) · Biology of Reproduction · doi:10.1093/biolre/ioz220 · Cited by 7 · see citing works
“When those hemostatic systems are impaired during postpartum hemorrhage, OT or its analog carbetocin could be used as a hemostatic agent [49].”
Background
Changes in Maternal Body Mass Index, Weight Gain and Outcome of Singleton Pregnancies from 2000 to 2015
Noever, K., Schubert, J., Reuschel, E., Timmesfeld, N., & Arabin, B. (2020) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-1110-0859 · Cited by 7 · see citing works
“Antenatal risk factors for PPH include multiple pregnancy, anemia, macrosomia, placenta previa or increta, previous PPH, as well as obesity and advanced maternal age [39].”
Background
Safety and efficacy of a novel three‐dimensional magnetic resonance imaging model for uterine incision in placenta previa
Cao, Y., Wei, Y., Yu, Y., & Wang, Z. (2017) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12311 · Cited by 7 · see citing works
“Postpartum hemorrhage was defined as blood loss greater than 1000 mL within 24 hours of delivery [9].”
Background
Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony
Moleiro, M. L., Guedes‐Martins, L., Mendes, A., Marques, C., & Braga, J. S. (2018) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1055/s-0037-1613690 · Cited by 7 · see citing works
Synthesis of oxytocin derivatives lipidated via a carbonate or carbamate linkage as a long-acting therapeutic agent for social impairment-like behaviors
Михайлович, Ч. С., Miura, R., Shabalova, A. A., Ichinose, W., Yokoyama, S., Fukuda, H., Watanabe, M., Higashida, H., & Shuto, S. (2019) · Bioorganic & Medicinal Chemistry · doi:10.1016/j.bmc.2019.06.018 · Cited by 6 · see citing works
Predictors of time to recovery from postpartum hemorrhage in Debre Markos comprehensive specialized hospital, Northwest, Ethiopia, 2020/21
Kassie, B., Ahmed, B., & Degu, G. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04834-5 · Cited by 6 · see citing works
Assessment of postpartum haemorrhage for placenta accreta: Is measurement of myometrium thickness and dark intraplacental bands using MRI helpful?
Chen, X., Ying, M., Xu, H., Xin, Y., Yang, L., Liu, Z., Han, Y., Huang, Z., Liu, Q., & Zhang, J. (2022) · BMC Medical Imaging · doi:10.1186/s12880-022-00906-2 · Cited by 6 · see citing works
Approaches to Hysterectomy
Amarin, Z. O. (2015) · InTech eBooks · doi:10.5772/59454 · Cited by 6 · see citing works
Promptness of oxytocin administration for first-line treatment of postpartum hemorrhage: a national vignette-based study among midwives
Voillequin, S., Rozenberg, P., Ravaud, P., & Rousseau, A. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04648-5 · Cited by 6 · see citing works
Improved Treatment of Postpartum Hemorrhage: Design, Development, and Bench-Top Validation of a Reusable Intrauterine Tamponade Device for Low-Resource Settings
Hu, K., Lapinski, M. M., Mischler, G., Allen, R. H., Manbachi, A., & Seay, R. C. (2020) · Journal of Medical Devices · doi:10.1115/1.4045965 · Cited by 6 · see citing works
The Association of Serum Fibrinogen Levels With the Severity of Primary Postpartum Hemorrhage: A Prospective Study
Kaur, K., Grover, S., Kukar, N., Tapasvi, I., Garg, M., & Singla, R. (2024) · Cureus · doi:10.7759/cureus.71397 · Cited by 5 · see citing works
“Postpartum hemorrhage (PPH) is an unpredictable obstetric emergency that is a direct cause of 1,32,000 maternal deaths worldwide every year [1].”
Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
Berg, K. M., Bray, J., Djärv, T., Drennan, I. R., Greif, R. T., Liley, H. G., Scholefield, B. R., Atkins, D. L., Carlson, J. N., de Caen, A. R., et al. (2025) · Resuscitation · doi:10.1016/j.resuscitation.2025.110805 · Cited by 5 · see citing works
Faktor Risiko Kejadian Atonia Uteri
Lestari, M., Mulawardhana, P., & Utomo, B. (2020) · Pediomaternal Nursing Journal · doi:10.20473/pmnj.v5i2.13459 · Cited by 5 · see citing works
Resuscitative efficacy of hemoglobin vesicles for severe postpartum hemorrhage in pregnant rabbits
Ishibashi, H., Hagisawa, K., Kinoshita, M., Yuki, Y., Miyamoto, M., Kure, T., Sakai, H., Saitoh, D., Terui, K., & Takano, M. (2021) · Scientific Reports · doi:10.1038/s41598-021-01835-w · Cited by 6 · see citing works
PREVENTION AND TREATMENT OF POSTPARTUM HEMORRHAGE: A LITERATURE REVIEW
Bitbit, Y. R., Ahmad, M., & Sunarno, I. (2022) · Nurse and Health Jurnal Keperawatan · doi:10.36720/nhjk.v11i1.304 · Cited by 5 · see citing works
“World Health Organization reveals that the leading cause of maternal death is postpartum bleeding (Dunkerton et al., 2018; Khan et al., 2006; Lalonde, 2012; Weeks, 2015).”
Background
Prophylactic uterotonics in the prevention of primary postpartum haemorrhage for unplanned out-of-hospital births: a literature review
Greenaway, M. (2019) · British Paramedic Journal · doi:10.29045/14784726.2019.03.3.4.15 · Cited by 5 · see citing works
“Greenaway, M, British Paramedic Journal 2019, vol. 3(4) 15–22 There is some debate about whether mixed management (a combination of both active and physiological management) may be of greater benefit in reducing postpartum blood loss (Begley, Gyte, Devane, McGuire, & Weeks, 2015).”
BackgroundInfluential
Timing and Outcomes of an Indication‐Only Use of Intravenous Cannulation During Spontaneous Labor
Bailey, J. M., Bell, C. L., & Zielinski, R. (2019) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13046 · Cited by 5 · see citing works
Uterine Tonus Assessment by Midwives versus Patient self-assessment in the active management of the third stage of labor (UTAMP): study protocol for a randomized controlled trial
Browne, J. L., Damale, N., Raams, T. M., van der Linden, E. L., Maya, E. T., Doe, R. D., Rijken, M. J., Adanu, R., Grobbee, D. E., Franx, A., et al. (2015) · Trials · doi:10.1186/s13063-015-1111-5 · Cited by 5 · see citing works
Avaliação da assistência de enfermagem na hemorragia pós-parto
Vieira, S. N., Vidigal, B. A. A., Inácio, A. S., Norte, A. D. S. D., & Vasconcelos, M. N. G. (2018) · Revista de Enfermagem UFPE on line · doi:10.5205/1981-8963-v12i12a236179p3247-3253-2018 · Cited by 5 · see citing works
Improving blood transfusion services
Tancred, T., & Bates, I. (2019) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2019.05.007 · Cited by 5 · see citing works
Peripartum Hysterectomy
Amarin, Z. O. (2015) · InTech eBooks · doi:10.5772/60942 · Cited by 5 · see citing works
Midwives’ experiences with implementation of active management of third stage of labor in Sub-Saharan Africa: a systematic review
Danquah, E., & Morgan, A. K. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07331-7 · Cited by 4 · see citing works
“Given that CCT and uterine massage are essential for managing retained placenta or uterine atony [27, 32, 71], ongoing training should encompass all AMTSL components.”
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Background
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Re: The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?
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Postpartum Haemorrhage, A Persisting Killer Around the Globe, Road Ahead
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Postpartum Hemorrhage: Evidence-Based Prophylaxis
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Postpartum Haemorrhage
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Authors: Weeks, A.
Affiliations: University of Liverpool (GB)
Corresponding author: Weeks, A
ORCID: Weeks, A
Venue: BJOG: An International Journal of Obstetrics & Gynaecology
Publisher: Wiley
Published: 2014-10-07
Volume: 122
Issue: 2
Pages: 202-210
ISSN: 0306-5456 (ISSN-L)
1470-0328
1471-0528
DOI: 10.1111/1471-0528.13098
OpenAlex: W1984295142
Cited by: 192
References: 63
Citations by year: 2026: 8 · 2025: 14 · 2024: 11 · 2023: 17 · 2022: 27 · 2021: 21 · 2020: 24 · 2019: 21 · 2018: 12 · 2017: 12 · 2016: 16 · 2015: 7 · 2014: 1
FWCI: 1.81
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
PubMed (publishedVersion)
Funders: Gynuity Health Projects (MamaMiso)
NIHR (II-LA-0712-20007)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Health Sciences › Medicine › Biochemistry › Blood transfusion and management
Keywords: postpartum hemorrhage, maternal mortality, controlled cord traction, misoprostol, oxytocin, placental abruption, placenta previa, bleeding prevention
MeSH terms: Blood Transfusion, Delivery of Health Care, Female, Postpartum Hemorrhage, Home Childbirth, Humans, Labor Stage, Third, Oxytocics, Pregnancy, Compression Bandages

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The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?

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