<unk>  is classified according to the duration between the delivery and<unk>  into 2 groups: primary (within the first 24 hours after birth) and secondary (between 24 hours and 12 weeks after birth). The pathophysiology of<unk>  depends on the underlying etiology. It is important to differentiate the underlying etiology of<unk>  for deciding the treatment. The most common cause of<unk>  is uterine atony. Less common causes of<unk>  include obstetrical lacerations, retained placental tissue, and maternal coagulation disorders. The incidence of<unk>  (the leading cause of maternal deaths) is approximately 4,000-6,000  per 100,000 individuals with a case-fatality rate of 7.5%. Common risk factors in the development of<unk>  include the prolonged third stage of labor, preeclampsia, Asian race, and previous<unk> . Risk factors in the development of<unk>  further differentiate depending on the cause. The diagnosis of<unk>  is based on the amount of blood loss and clinical presentation of the patient, which include either blood loss ≥1000 mL (regardless of the form of the delivery) or the presence of tachycardia and hypotension in a patient with blood loss.<unk>  is traditionally described as blood loss > 500 mL after a vaginal delivery or blood loss > 1000 mL after a cesarean delivery. Physical examination may provide the underlying etiology of<unk>  such as the presence of a soft, large and boggy uterus which indicates uterine atony. Laboratory values that should be obtained on admission to delivery include complete blood count, basic metabolic panel, blood type/screening, fibrinogen, PT, and aPTT. Ultrasound may be helpful in the diagnosis of the underlying etiology of<unk> . IV catheter placement, foley catheter placement, bimanual uterine massage, manual exploration of the uterine cavity with the evacuation of retained placental tissue or blood clots, and intravenous fluid therapy are recommended among all patients who develop<unk> . If present, genital tract lacerations should immediately be repaired with absorbable sutures. Pharmacologic medical therapies for<unk>  include either oxytocin (first-line), methylergonovine, carboprost, or misoprostol. Placement of an arterial catheter, placement of a central venous catheter, placement of a uterine balloon tamponade, tranexamic acid administration, and blood transfusion should additionally be considered in patients with estimated blood loss ≥1500-3000 mL. Embolization of the uterine artery should be considered among hemodynamically stable patients resistant to medical treatment. Surgery is not the first-line treatment option for patients with<unk> . Surgery is usually reserved for patients either with bleeding resistant to the less invasive measures, estimated blood loss ≥ 3000 mL, or hemodynamic instability. As a method of primary prevention, the active management of the third stage of labor (AMTSL) compared to the physiological (expectant) management reduces the risk of<unk> .
Postpartum hemorrhage
Antepartum haemorrhage
Obstetrical hemorrhage
Preeclampsia
Pre-eclampsia
Eclampsia
Placenta accreta
Maternity blues