New Global Guidelines Aim to Reduce Maternal Deaths from Postpartum Hemorrhage

Major health organizations have released updated guidelines to address postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide. These new recommendations emphasize early detection and swift intervention to prevent deaths and long-term health consequences for women. PPH, characterized by heavy bleeding after childbirth, results in approximately 45,000 deaths annually and can cause severe health issues such as organ damage or hysterectomy, even if not fatal.

According to recent studies included in the guidelines, many cases of PPH occur without identifiable risk factors, underlining the importance of vigilant monitoring during and after labor. The guidelines introduce new diagnostic criteria, urging healthcare providers to act when blood loss reaches 300 mL or if abnormal vital signs are observed, rather than waiting for the traditional 500 mL threshold.

To facilitate early detection, the use of calibrated drapes—devices that accurately measure blood loss—is recommended. Once PPH is diagnosed, immediate actions, known as the MOTIVE bundle, should be implemented swiftly. This includes uterine massage, administration of oxytocic drugs, tranexamic acid to reduce bleeding, intravenous fluids, examination of the genital tract, and escalation of care if bleeding persists. In critical cases, surgical intervention or blood transfusions may be necessary to stabilize the woman.

Prevention strategies focus on comprehensive antenatal and postnatal care, particularly addressing maternal anemia through iron supplementation and avoiding unsafe practices such as routine episiotomies. For the third stage of labor, administering uterotonics like oxytocin or heat-stable carbetocin is recommended, with misoprostol as an alternative where cold chain storage is an issue.

The guidelines also call upon governments, healthcare systems, and partners to support midwives and healthcare workers through training and resource provision. Developed with organizations like UNFPA, they include practical training modules and simulation exercises. Launched during the 2025 FIGO World Congress, these guidelines are part of the global initiative to eliminate preventable PPH deaths by 2030, presenting 51 evidence-based recommendations to prevent, diagnose, and treat postpartum hemorrhage effectively.

For more information, see the original research in The Lancet Global Health.

source: https://medicalxpress.com/news/2025-10-global-health-agencies-issue-deaths.html