Abstract
Major obstetric hemorrhage is an extremely challenging obstetric emergency associated with
significant morbidity and mortality. Pharmacological treatment of uterine atony has not altered
much in recent years apart from the increasing use of misoprostol, although controversy surrounds
its advantages over other uterotonics. Placenta accreta is becoming more common, a sequel to the
rising caesarean section rate. Interventional radiology may reduce blood loss in these cases. Uterine
compression sutures, intrauterine tamponade balloons and cell salvage have been introduced in the
last decade.