Leading reproductive health organizations have unveiled new guidelines to tackle postpartum hemorrhage (PPH), a serious condition affecting many women after childbirth. PPH, defined as excessive bleeding, results in around 45,000 deaths worldwide each year, making it one of the top causes of maternal mortality. Even in survivors, PPH can lead to severe health problems, including anxiety and organ damage.
Dr. Jeremy Farrar, a health expert, emphasizes the urgent need for quick detection and treatment. He notes that many deaths from PPH can be prevented with proper care. These guidelines aim to improve outcomes, especially in areas where healthcare resources are limited.
The new guidelines recommend changes to how PPH is diagnosed and managed. They now suggest acting when a woman loses 300 mL of blood, rather than the previous threshold of 500 mL. This shift highlights the importance of close monitoring right after birth. Simple tools, like calibrated drapes that measure blood loss, can help health workers respond faster.
Once PPH is diagnosed, a series of essential steps should be taken immediately, known as the MOTIVE bundle:
- Massage of the uterus
- Oxytocic drugs to promote contractions
- Tranexamic acid (TXA) to reduce bleeding
- Intravenous fluids
- Vaginal examination
- Escalation of care if necessary
For ongoing bleeding, more advanced treatments, such as surgery or blood transfusions, may be required.
Experts underline that good prenatal and postnatal care can significantly reduce PPH risks. For example, addressing anemia—common in poorer countries—can lessen the chance of severe bleeding. Recommendations include daily iron supplements for pregnant women and timely intravenous iron if needed.
The guidelines also advise against unnecessary medical procedures like routine episiotomies, promoting safer options like perineal massage during pregnancy to prevent trauma that could lead to PPH.
Professor Jacqueline Dunkley-Bent, Chief Midwife at the International Confederation of Midwives, calls these guidelines a “game-changer.” She stresses that for real progress, investment in healthcare and midwives is essential.
The launch of these comprehensive guidelines coincides with the fight against postpartum hemorrhage in the Global roadmap from 2023 to 2030.
According to a recent WHO study involving over 300,000 women across 23 countries, the new diagnostic measures are backed by robust evidence, highlighting the need for healthcare systems to adapt and implement these changes.
For more detailed information on the guidelines, please refer to the original article published in The Lancet here: The Lancet Study.
