Conclusion
Postpartum hemorrhage is an unpredictable and rapid
cause of maternal death worldwide. Current evidence
indicates that—where appropriately trained birth
attendants, necessary equipment, and injection safety can
be ensured—active management of the third stage of labor
(uterotonic drugs, cord clamping, and controlled cord
tension) will significantly reduce the incidence of PPH.
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Together with the prevention and treatment of anemia
and skilled attendance at all deliveries, active management
can prevent PPH in thousands of women worldwide each
year. Those cases that cannot be prevented require the
immediate intervention of skilled, well-equipped providers.
Ongoing operations research is helping to determine
the best approaches for managing postpartum bleeding and