[CG] Post-natal bleeding ≤ 6 completed weeks from delivery

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(if > 6weeks – refer to Gynaecology)
Review history – Labour / Delivery and 3rd stage.

There are no randomised controlled trials to inform the management of secondary PPH (Cochrane 2002).

The diagnosis and management of secondary PPH primarily relies on clinical assessment. Ultrasound has a high false positive rate as it is difficult to differentiate between retained products and blood clot.

  1. Assess the woman
    1. Estimate total blood loss
    2. Vital signs (temperature, pulse, blood pressure)
    3. Follow either Flow chart A (stable patient) or Flow chart B (patient clinically unwell).

Flow chart A : Patient stable

Flow chart B : Patient clinically unwell

Last reviewed: 16 August 2018

Next review: 01 August 2021

Author(s): Julie Murphy

Version: 2

Approved By: Dr C Bain, Clinical Director, Obstetrics GGC