Postpartum hemorrhage
Blood loss exceeding 500 mL after vaginal birth or 1000 mL after cesarean. Main cause — uterine atony. Per WHO 2022 — oxytocin first-line; if inadequate, misoprostol, ergometrine, carboprost, tranexamic acid, balloon tamponade, and surgical interventions.
ICD-10 O722 drugs
Also known as: PPH
Drugs used for this condition
- AOxytocinFirst line · Posterior pituitary hormonesFirst-line for prevention and treatment of uterine atony postpartum hemorrhage per WHO 2022 and FIGO 2018. Prophylaxis: 10 IU IM or 5 IU IV immediately after birth. Treatment: 20–40 IU in 1 L saline IV drip, combined with methylergometrine, misoprostol, or carboprost as needed. Tranexamic acid is added for persistent bleeding.
- ATranexamic acidFirst line · Antifibrinolytics, amino acidsFirst-line for postpartum hemorrhage per WHO 2022 and FIGO 2018. The WOMAN trial (Lancet 2017, over 20,000 patients) showed a 19 % reduction in death from bleeding when given within 3 hours of birth. Dose 1 g IV over 10 minutes, repeat after 30 minutes if bleeding persists. WHO recommends mandatory availability in maternity facilities.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit