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Sadık Kükrer, MDObstetrics & Gynecology · Adana, Türkiye
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Postpartum Haemorrhage: What Has Changed?

Last updated: 25 October 2026 · Editor: Sadık Kükrer, MD

  • Diagnostic threshold: blood loss of 500 mL or more, or 300 mL or more with an abnormal clinical sign (Gallos 2025; WHO/FIGO/ICM 2025).
  • The decision rule uses a shock index >1.0 (Gallos 2025).
  • Blood loss is measured, not estimated visually (ACOG CO 794; E-MOTIVE).
  • E-MOTIVE: early detection plus a treatment bundle reduced the composite primary outcome (RR 0.40; 95% CI 0.32–0.50). The trial included vaginal births only.
  • Tranexamic acid should be given early; its benefit falls by about 10% for every 15-minute delay (Gayet-Ageron 2018).
  • The pooled success rate of balloon tamponade is 85.9% (Suarez 2020).

References

  1. Gallos I, et al. N Engl J Med. 2023;389(1):11-21. doi:10.1056/NEJMoa2303966. PMID: 37158447.
  2. Gallos I, et al. Lancet. 2025;406(10514):1969-1982. doi:10.1016/S0140-6736(25)01639-3. PMID: 41056961.
  3. World Health Organization, FIGO, ICM. Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage. Geneva: WHO; 2025. ISBN 978-92-4-011563-7. https://www.who.int/publications/i/item/9789240115637
  4. American College of Obstetricians and Gynecologists. Committee Opinion No. 794. Obstet Gynecol. 2019;134(6):e150-e156. doi:10.1097/AOG.0000000000003564. PMID: 31764759.
  5. Gayet-Ageron A, et al. Lancet. 2018;391(10116):125-132. doi:10.1016/S0140-6736(17)32455-8. PMID: 29126600.
  6. Suarez S, et al. Am J Obstet Gynecol. 2020;222(4):293.e1-293.e52. doi:10.1016/j.ajog.2019.11.1287. PMID: 31917139.