Summary: PPH is the most common form of major obstetric haemorrhage. The traditional definition of primary PPH is the loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby. PPH can be minor (500–1000 ml) or major (more than 1000 ml). Major could be divided to moderate (1000–2000 ml) or severe (more than 2000 ml). The recommendations in this guideline apply to women experiencing primary PPH of 500 ml or more.
Women with pre-existing bleeding disorders and women taking therapeutic anticoagulants are at increased risk of PPH; this guideline does not include specific recommendations for the management of such situations or for managing haemorrhage in women who refuse blood transfusion. Guidance on these topics is available from other sources.
Version history
The first edition of this guideline was published in 2009; reviewed 2011 – minor update required. This is the second edition of this guideline, published in 2017; reviewed in 2023 – an update is in development that will result in two guidelines, No 52a Prevention of Postpartum Haemorrhage and No 52b Management of Postpartum Haemorrhage.
Developer declaration of interests
Ms E Mavrides: None declared.
Dr S Allard: None declared.
Dr E Chandraharan: Dr Chandraharan runs cardiotocography masterclasses for the charity Baby Lifeline.
Professor P Collins: Professor Collins receives research support from CSL Behring, TEM International and Haemonetics.
Dr L Green: None declared.
Professor BJ Hunt: None declared.
Mr S Riris: None declared.
Dr AJ Thomson: Dr Thomson has sat on advisory boards for Leo Pharma and Alliance Pharma.