PPH Recognition and Management Escalation

Obstetrics & Gynaecology

Postpartum haemorrhage (PPH) is a time-critical obstetric emergency in which early recognition and prompt escalation of treatment are essential to prevent severe maternal complications. Assessment should include ongoing blood loss, uterine tone, maternal vital signs, hemodynamic status, and response to initial interventions. Identifying the underlying cause using the four Ts—Tone, Trauma, Tissue, and Thrombin—helps guide targeted management. Initial measures may include uterine massage, uterotonics, tranexamic acid, intravenous fluid resuscitation, and blood component therapy when indicated. Persistent bleeding or clinical deterioration requires rapid escalation to measures such as balloon tamponade, interventional procedures, or surgery. Clear protocols, effective teamwork, and timely communication are vital to improving maternal outcomes.Please participate in the survey and share your opinion on PPH recognition and management escalation.

What is the traditional PPH threshold after cesarean delivery?

• ≥1,000 mL
• ≥500 mL
• ≥750 mL
• ≥1,500 mL

According to you, what should guide escalation of PPH management?

• Bleeding, hemodynamics, and response to treatment
• Estimated blood loss alone
• Hemoglobin alone
• None of the above