New WHO guidelines to prevent deaths from excessive bleeding after childbirth

The World Health Organization (WHO) introduced new guidelines aimed at preventing, diagnosing, and treating postpartum haemorrhage (PPH), a serious condition causing excessive bleeding after childbirth, which is a leading cause of maternal mortality worldwide

Co-published with the International Federation of Gynecology and Obstetrics and the International Confederation of Midwives, these guidelines emphasize the need for earlier detection and faster intervention to save lives and reduce long-term health impacts

PPH is responsible for nearly 45,000 maternal deaths each year and can cause significant physical and mental health issues, such as organ damage, anxiety, or trauma, even when not fatal

A key change in the guidelines is the recommendation for clinicians to act when blood loss reaches 300 mL, rather than the traditional 500 mL, along with monitoring abnormal vital signs to diagnose PPH earlier

The guidelines encourage healthcare workers to closely monitor women post-birth using calibrated drapes to accurately measure blood loss and act swiftly when necessary

Once PPH is diagnosed, the recommended "MOTIVE" bundle of actions includes uterine massage, administration of oxytocic drugs, tranexamic acid, intravenous fluids, and examination of the vaginal and genital tract, with escalation of care if needed

For severe cases where bleeding persists, the guidelines suggest surgical interventions or blood transfusions to stabilize the woman until further treatment can be provided

The guidelines stress the importance of comprehensive antenatal and postnatal care to address risk factors like anaemia, which is prevalent in low-income countries and increases PPH risks

Recommendations for managing anaemia include daily oral iron and folate supplements during pregnancy and intravenous iron transfusions when immediate correction is required, such as after PPH or if oral treatment is ineffective

These guidelines aim to improve maternal health outcomes, particularly in resource-limited settings, ensuring more women survive childbirth and return home safely to their families