Obstetric haemorrhage

Postpartum hemorrhage is a major cause of maternal morbidity and mortality. In fact, in many developing countries, postpartum hemorrhage is the leading cause of maternal mortality. Several treatment options are available. Whereas in the past, postpartum hemorrhage almost inevitably lead to hysterectomy and therefore loss of fertility, today, more conservative alternatives can be used with preservation of fertility. These conservative approaches have proven to be useful, especially when performed early when basic haemostatic procedures have failed. However, hysterectomy should not be delayed when the conservative approach fails particularly in remote areas where supplies of fluids and blood may be limited. Close monitoring, good teamwork and timely clinical decision making are vital.