uterine, utero ovarian, or hypogastric vessel ligation may be attempted. At Beijing Haidian Maternal and Child Health Hospital, manual uterine massage and compressions are recommended as the first measure when PPH is unresponsive to conventional uterotonics. If uterine massage and compressions are ineffective, bilateral ligation of the uterine arteries should be performed. If these methods do not control blood loss, the uterine cavity should be packed with gauze.