WHO Guidelines for the Management of Postpartum Haemorrhage and Retained Placenta

Excerpt

One of the Millennium Development Goals set by the United Nations in 2000 is to reduce maternal mortality by three-quarters by 2015. If this is to be achieved, maternal deaths related to postpartum haemorrhage (PPH) must be significantly reduced. In support of this, health workers in developing countries need to have access to appropriate medications and to be trained in relevant procedures. But beyond this, countries need evidence-based guidelines on the safety, quality, and usefulness of the various interventions. These will provide the foundation for the strategic policy and programme development needed to ensure realistic and sustainable implementation of appropriate interventions. PPH is generally defined as blood loss greater than or equal to 500 ml within 24 hours after birth, while severe PPH is blood loss greater than or equal to 1000 ml within 24 hours. PPH is the most common cause of maternal death worldwide. Most cases of morbidity and mortality due to PPH occur in the first 24 hours following delivery and these are regarded as primary PPH whereas any abnormal or excessive bleeding from the birth canal occurring between 24 hours and 12 weeks postnatally is regarded as secondary PPH.