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.
COVID disclaimer: This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.
Version history: This is the second edition of this guideline; the third edition is currently in development.
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.