Medical therapies for primary postpartum hemorrhage

Severe postpartum hemorrhage remains an important cause of maternal morbidity and mortality. The most common cause of postpartum hemorrhage is uterine atony. For first line management of postpartum hemorrhage adequate blood and fluid replacement is mandatory. Further therapeutic measures consist of a variety of medical interventions and surgical techniques. A management protocol for treatment of massive obstetric hemorrhage should be available at every delivery unit. Medical therapies that have been reported to successfully control postpartum hemorrhage include administration of uterotonics, and more recently tranexamic acid and recombinant activated factor VII.