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Postpartum hemorrhage (PPH) is an obstetric emergency that occurs in 1 to 5% of both vaginal and cesarean deliveries. PPH is a major cause of maternal morbidity, with sequela such as hemodynamic shock, renal failure, acute respiratory distress syndrome, coagulopathy, and Sheehan's syndrome. PPH is also one of the top five causes of maternal mortality in both developed and developing countries, although the absolute risk of death is much lower in the former than the latter (1 in 100,000 versus 1 in 1000 births).2PPH is defined as estimated blood loss of ≥ 500 mL after vaginal delivery or ≥ 1000 mL after cesarean section.3,4 Another definition of PPH is a reduction in the patient's hematocrit level of more than 10% compared with the prenatal value or blood loss causing hemodynamic instability of sufficient degree to require blood transfusion.5,6
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