6. How should PPH be managed?
Once PPH has been identified, management involves four components, all of which must be undertaken
SIMULTANEOUSLY: communication, resuscitation, monitoring and investigation, arresting the bleeding.
The practical management of PPH may be considered as having at least four components: communication
with all relevant professionals; resuscitation; monitoring and investigation; measures to arrest the
bleeding. Each of these components is discussed in turn in the guideline but, it must be emphasised, these
components must be initiated and progressed simultaneously for optimal patient care.It is important to be
aware that minor PPH can easily progress to major PPH and is sometimes unrecognised.
The pattern of management presented in this guideline is dependent on the woman being cared for in a
consultant-led maternity unit with access to laboratory and blood bank facilities and with skilled obstetric and
anaesthetic staff readily available. On occasions where primary PPH occurs in a woman delivering in a
different setting (such as at home or in a midwife-led maternity unit), the role of the professionals on site is
to institute ‘first aid’ measures while arranging transport to a consultant-led maternity unit by the most
expeditious means.
6.1 Communication
Who should be informed when the woman presents with postpartum haemorr