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Maternal-Fetal MedicineSociety
SG-005ProtocolHaemorrhage

Management of postpartum haemorrhage

Prevention, early recognition, a stepwise management algorithm, the massive transfusion protocol and team communication.

Version 3.228 pagesUpdated 4 September 2025Emergency Care Working Group

Key recommendations

  • Active management of the third stage at every birth
  • Quantitative (not visual) estimation of blood loss
  • Tranexamic acid within three hours of diagnosis
  • Activate the massive transfusion protocol above 1,500 mL

The protocol is built on a stepwise principle: each stage defines the action, the person responsible and the criterion for escalating.

Drills

A massive haemorrhage scenario drill is recommended once a quarter, involving every on-call team.

Note: A guideline is a recommendation and does not replace the clinician's professional judgement in an individual case. Departing from it is acceptable where the reasoning is documented.