Postpartum hemorrhage is defined as blood loss of ≥500 mL for vaginal delivery after completion of the 3rd stage of labor while for cesarean delivery, the cut-off is 1000 mL.
It may present as either early (primary) or late (secondary) postpartum hemorrhage.
Postpartum hemorrhage may produce hemodynamic instability during the 1st 24 hours after delivery.
  1. Anderson JM, Etches D. Prevention and management of postpartum hemorrhage. Am Fam Physician. 2007 Mar;75(6):875-882. PMID: 17390600
  2. International Confederation of Midwives, International Federation of Gynecology and Obstetrics, and Society of Obstetricians and Gynaecologists of Canada. Management of the third stage of labor to prevent postpartum hemorrhage. J Obstet Gynaecol Can. 2003 Nov;25(11):952-955. PMID: 14608446
  3. Firouzbakht M, Kiapour A, Omindar S. Prevention of postpartum hemorrhage by rectal Misoprostol: a randomized clinical trial. J Nat Sci Biol Med. 2013 Jan;4(1):134-137. doi: 10.4103/0976-9668.107277. PMID: 23633849
  4. Lalonde A; International Federation of Gynecology and Obstetrics. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2012 May;117(2):108-118. doi: 10.1016/j.ijgo.2012.03.001. PMID: 22502595
  5. Martel MJ, MacKinnon KJ, Arsenault MY, et al. Hemorrhagic shock. J Obstet Gynaecol Can. 2002 Jun;24(6):504-511. PMID: 12196857
  6. Maughan KL, Heim SW, Galazka SS. Preventing postpartum hemorrhage: managing the third stage of labor. Am Fam Physician. 2006 Mar;73(6):1025-1028. PMID: 16570736
  7. Leduc D, Senikas V, Lalonde AB, et al. Active management of the third stage labour: prevention and treatment of postpartum hemorrhage. J Obstet Gynaecol Can. 2009 Oct;31(10):980-993. PMID: 19941729
  8. Schuurmans N, Mackinnon C, et al. Prevention and management of postpartum hemorrhage. J Soc Obstet Gynaecol Can. 2000;22(4):271-281.
  9. Shane B; Program for Appropriate Technology in Health (PATH). Preventing postpartum hemorrhage: managing the third stage of labor. Outlook. 2001 Sep;19(3):1-8
  10. Mousa HA, Alfirevic Z. Treatment of primary postpartum haemorrhage: managing the third stage of labor. Cochrane Database Syst Rev. 2007 Jan(1):CD003249. PMID: 17253486
  11. Gabbe S. Postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics normal and problem pregnancies. 4th. New York: Churchill Livingstone, Inc; 2002:521-536.
  12. Cunningham F, Macdonald P, et al. Obstetrical hemorrhage. William's Obstetrics. 20th. Stamford: Appleton and Lange; 1997.
  13. MedWorm
  14. National Institute for Health and Care Excellence. Intrapartum care. Care of healthy women and their babies during childbirth. NICE. Sep 2007.
  15. The Royal Women’s Hospital. Labour: management of post-partum haemorrhage, including postnatal care. Mar 2012. Accessed 10 May 2013.
  16. Demott K, Bick D, Norman R, et al. 2006 Clinical guidelines and evidence review for postnatal care: routine postnatal care of recently delivered women and their babies. London. National Collaborating Centre for Primary Care and Royal College of General Practitioners. 2006.
  17. Royal College of Obstetricians and Gynaecologists. Prevention and management of postpartum haemorrhage. Green-top guideline no. 52. 2009. Accessed 10 May 2013.
  18. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. WHO. 2012. Accessed 26 Apr 2013.
  19. Smith JR, Brennan BG. Postpartum hemorrhage. eMedicine. Accessed 04 Jun 2010.
  20. Yiadom MY, Carusi D. Pregnancy, postpartum hemorrhage. eMedicine. Accessed 04 Jun 2010.
  21. Tunçalp Ö, Hofmeyr GJ, Gülmezoglu AM. Prostaglandins for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2012;8:CD000494. doi: 10.1002/14651858.CD000494.pub4. PMID: 22895917
  22. Belfort MA. Overview of postpartum hemorrhage. UpToDate. 29 Mar 2017.
  23. Mavrides E, Allard S, Chandraharan E, et al on behalf of the Royal College of Obstetricians and Gynaecologists. Prevention and management of postpartum haemorrhage: Green-top guideline no. 52. BJOG. 2017 Apr;124(5):e106-e149. doi: 10.1111/1471-0528.14178. PMID: 27981719
  24. Chandraharan E, Krishna A. Diagnosis and management of postpartum haemorrhage. BMJ. 2017 Sep 27;358:j3875. doi: 10.1136/bmj.j3875. Accessed 24 Sep 2018. PMID: 28954732
  25. Demers C, Derzko C, David M, et al. No. 163-Gynaecological and obstetric management of women with inherited bleeding disorders. J Obstet Gynaecol Can. 2018 Feb;40(2):e91-e103. doi: 10.1016/j.jogc.2017.11.036. PMID: 29447730
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