Health Systems and Organization of Care recommendations for the prevention and treatment of postpartum haemorrhage

Health Systems and Organization of Care recommendations for the prevention and treatment of postpartum haemorrhage

 

Recommendations

 

The use of formal protocols by health facilities for the prevention and treatment of PPH is recommended.

The use of formal protocols for referral of women to a higher level of care is recommended for health facilities.

The use of simulations of PPH treatment is recommended for pre-service and in-service training programmes.

Monitoring the use of uterotonics after birth for the prevention of PPH is recommended as a process indicator for programmatic evaluation.

 

Weak recommendations, very-low-quality evidence

 

Publication date: September 2012

 

Remarks

• Routine and frequent uterine tone assessment remains a crucial part of immediate postpartum care, particularly for optimizing the early diagnosis of PPH.

• The GDG acknowledged that the implementation of formal protocols is a complex process which will require the local adaptation of general guidelines.

• The GDG placed a high value on the costs of simulation programmes and acknowledged that there are different types of simulation programmes. Some programmes are hi-tech, computerized and costly while others are less expensive and more likely to be affordable in low- and middle-income countries. The GDG identified improvement in communication between health care providers and patients and their family members as an important priority in the training of health care providers in PPH management.

• The GDG recommended monitoring the use of prophylactic uterotonics. This recommendation is based on experience from other areas of health care, particularly child health, where content-based health indicators are common and regarded as useful for programmatic purposes. The suggested indicator is calculated as the number of women receiving prophylactic uterotonic drugs after birth divided by all women giving birth.

 

WHO recommendations for the prevention and treatment of postpartum haemorrhage

Evidence Base and GRADE tables for these recommendations

 

Other WHO content related to these recommendations

Education material for teachers of midwifery

WHO RECOMMENDATIONS ON PREVENTION AND TREATMENT OF POSTPARTUM HAEMORRHAGE Highlights and Key Messages from New 2012 Global

Pregnancy, Childbirth, Postpartum and Newborn Care: A guide for essential practice

Managing Complications in Pregnancy and Childbirth: A guide for midwives and doctors

 

This recommendation should be cited as: WHO Reproductive Health Library. Health Systems and Organization of Care recommendations for the prevention and treatment of PPH (last revised 2012). The WHO Reproductive Health Library; Geneva: World Health Organization.