Specific Management of PPH

Postpartum haemorrhage can suddenly turn happy events into a tragedy. Definitive management is the mainstay in stopping the bleeding. Therefore, the definitive management of postpartum haemorrhage must be prompt and precise, and stepwise. The chronology of steps needs to be understood and carried out systematically. The definitive management varies from pharmacological to non-invasive to surgical methods. The chapter brings out the concept of management in a stepwise manner and details the various surgical management procedures for atonic haemorrhage. The different types of trauma to the vagina, cervix, and perineum are discussed, along with the techniques of repair. The chapter discusses the concept of management in a stepwise manner and details the various surgical management procedures for atonic haemorrhage. Postpartum haemorrhage can suddenly turn happy events into a tragedy. Definitive management is the mainstay in stopping the bleeding. Tranexamic acid is recommended for all cases of postpartum haemorrhage. The WHO recommends its use in all cases of PPH irrespective of the cause. The significant problems with these procedures are uterine necrosis and deep vein thrombosis. Hemoperitoneum might occur while approaching the internal iliac arteries during the process of negotiation into the vessels. The internal iliac artery is ligated with the help of right-angled artery forceps. One must be careful of the internal iliac vein running inferiomedial to the artery and the external iliac vein running inferior and lateral while driving the right-angled forceps underneath the internal iliac artery from lateral to the medial side.