Postpartum Hemorrhage in Emergency Medicine Questions & Answers

1. Minino AM, Heron MP, Murphy SL, et al. National Vital Statistic Reports: Deaths 2004. US Department of Health and Human Services and the Centers for Disease Control and Prevention. August 21, 2007. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf.

2. World Health Organization. World Health Report 2005: Make Every Mother and Child Count. Available at http://www.who.int/whr/2005/whr2005_en.pdf. Accessed: September 10, 2008.

3. USAID (United States Agency for International Development). Postpartum Hemorrhage Prevention. USAID Postpartum Hemorrhage Prevention Initiative (POPPHI). Available at http://www.pphprevention.org/briefs_newsletters.php. Accessed: September 9, 2008.

4. PATH. Saving Mother's Lives: Initiative promotes proven strategy for preventing postpartum hemorrhage. PATH: Preventing Postpartum Hemorrhage. Available at http://www.path.org/projects/preventing_postpartum_hemorrhage.php. Accessed: September 9, 2008.

5. Miller S, Lester F, Hensleigh P. Prevention and treatment of postpartum hemorrhage: new advances for low-resource settings. J Midwifery Womens Health. 2004 Jul-Aug. 49(4):283-92. [QxMD MEDLINE Link]. [Full Text].

6. Menitove JE, McElligott MC, Aster RH. Febrile transfusion reaction: what blood component should be given next?. Vox Sang. 1982. 42(6):318-21. [QxMD MEDLINE Link].

7. Shimada E, Tadokoro K, Watanabe Y, et al. Anaphylactic transfusion reactions in haptoglobin-deficient patients with IgE and IgG haptoglobin antibodies. Transfusion. 2002 Jun. 42(6):766-73. [QxMD MEDLINE Link].

8. Popovsky MA. Transfusion and lung Injury. Transfusion Clin Biol. 2001. 8:272-7.

9. Kicklighter EJ, Klein HG. Hemolytic transfusion reactions. Linden JV, Bianco C, eds. Blood Safety and Surveillance. New York: Marcel Dekker; 2001. 47-70.

10. Tintinalli JE, Kelen GD, Stapczynski JS. Gynecology and Obstetrics: Post Partum Hemorrhage. Emergency Medicine: A Comprehensive Study Guide. 6th. New York: McGraw Hill; 2004. 682.

11. Mousa HA, Blum J, Abou El Senoun G, Shakur H, Alfirevic Z. Treatment for primary postpartum haemorrhage. Cochrane Database Syst Rev. 2014 Feb 13. 2:CD003249. [QxMD MEDLINE Link].

12. Sentilhes L, Lasocki S, Ducloy-Bouthors AS, et al. Tranexamic acid for the prevention and treatment of postpartum haemorrhage. Br J Anaesth. 2015 Apr. 114 (4):576-87. [QxMD MEDLINE Link].

13. Ducloy-Bouthors AS, Jude B, Duhamel A, et al, for the EXADELI Study Group. High-dose tranexamic acid reduces blood loss in postpartum haemorrhage. Crit Care. 2011. 15 (2):R117. [QxMD MEDLINE Link].

14. WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet. 2017 May 27. 389 (10084):2105-2116. [QxMD MEDLINE Link].

15. Practice Bulletin No. 183 Summary: Postpartum Hemorrhage. Obstet Gynecol. 2017 Oct. 130 (4):923-925. [QxMD MEDLINE Link].

16. Quibel T, Ghout I, Goffinet F, Salomon LJ, Fort J, Javoise S, et al. Active Management of the Third Stage of Labor With a Combination of Oxytocin and Misoprostol to Prevent Postpartum Hemorrhage: A Randomized Controlled Trial. Obstet Gynecol. 2016 Oct. 128 (4):805-11. [QxMD MEDLINE Link].

17. Brown T. Oxytocin Without Misoprostol Best for Postpartum Hemorrhage Prevention. Medscape Medical News. September 09, 2016; Accessed: December 16, 2016.

18. Fox S. Preparing for ob/gyn emergencies: ACOG issues tips. February 20, 2014. Available at http://www.medscape.com/viewarticle/820913. Accessed: February 25, 2014.

19. Committee opinion no. 590: preparing for clinical emergencies in obstetrics and gynecology. Obstet Gynecol. 2014 Mar. 123(3):722-5. [QxMD MEDLINE Link].

20. Soriano D, Dulitzki M, Schiff E, Barkai G, Mashiach S, Seidman DS. A prospective cohort study of oxytocin plus ergometrine compared with oxytocin alone for prevention of postpartum haemorrhage. Br J Obstet Gynaecol. 1996 Nov. 103(11):1068-73. [QxMD MEDLINE Link].

21. Winikoff B, Dabash R, Durocher J, Darwish E, Nguyen TN, Leon W, et al. Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women not exposed to oxytocin during labour: a double-blind, randomised, non-inferiority trial. Lancet. 2010 Jan 16. 375(9710):210-6. [QxMD MEDLINE Link].

22. Martin E, Legendre G, Bouet PE, Cheve MT, Multon O, Sentilhes L. Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage. Acta Obstet Gynecol Scand. 2015 Apr. 94 (4):399-404. [QxMD MEDLINE Link].

23. Howard TF, Grobman WA. The relationship between timing of postpartum hemorrhage interventions and adverse outcomes. Am J Obstet Gynecol. 2015 Aug. 213 (2):239.e1-3. [QxMD MEDLINE Link].

24. Sparrow AH, Schwemmer SS, Thompson KH. Radiosensitivity studies with woody plants. III. Predictions of limits of probable acute and chronic LD50 values from lognormal distributions of interphase chromosome volumes in gymnosperms. Radiat Res. 1976 Feb. 65(2):315-26. [QxMD MEDLINE Link].

25. [Guideline] World Health Organization (WHO). WHO recommendations for the prevention of postpartum haemorrhage. Geneva, Switzerland: World Health Organization (WHO). 2007. 116 p. [Full Text].

26. [Guideline] Escobar MF, Nassar AH, Theron G, et al. FIGO recommendations on the management of postpartum hemorrhage 2022. Int J Gynaecol Obstet. 2022 Mar. 157 Suppl 1:3-50. [QxMD MEDLINE Link]. [Full Text].

Maame Yaa A B Yiadom, MD, MPH Staff Physician, Department of Emergency Medicine, Cooper University Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School

Maame Yaa A B Yiadom, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, National Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Daniela Carusi, MD, MSc Instructor, Obstetrics and Gynecology and Reproductive Biology, Harvard Medical School; Consulting Physician, Department of Obstetrics and Gynecology, Medical Director, Department of General Ambulatory Gynecology, Brigham and Women's Hospital

Daniela Carusi, MD, MSc is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Reproductive Health Professionals, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Mark L Zwanger, MD, MBA, FACEP Emergency Medicine Physician

Mark L Zwanger, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Bruce M Lo, MD, MBA, RDMS, FACEP, FAAEM, FACHE, FAAPL, CPE Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital; Medical Director, Sentara Transfer Center; Professor and Assistant Program Director, Core Academic Faculty, Department of Emergency Medicine, Eastern Virginia Medical School; Board Member, American Academy of Emergency Medicine

Bruce M Lo, MD, MBA, RDMS, FACEP, FAAEM, FACHE, FAAPL, CPE is a member of the following medical societies: American Academy of Emergency Medicine, American Association for Physician Leadership, American College of Emergency Physicians, American College of Healthcare Executives, American Institute of Ultrasound in Medicine, Emergency Nurses Association, Medical Society of Virginia

Disclosure: Nothing to disclose.

Assaad J Sayah, MD, FACEP President and Chief Executive Officer, Cambridge Health Alliance

Assaad J Sayah, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Special thanks to Dr. Donnie Bell for his assistance with the "Imaging" section for this topic.

The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous author, Michael P Wainscott, MD, to the development and writing of this article.

• Print this section
• Print the entire contents of
• Print the entire contents of article