OP @The Fragger Fam From ACOG: Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1 L or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide. Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation (DIC), acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome). Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the US closely followed by DIC. In postpartum patients, it is important to recognize that the signs or symptoms of considerable blood loss (eg, tachycardia and hypotension) often do not present or do not present until blood loss is substantial. In a patient with tachycardia and hypotension, the obstetric care provider should be concerned that considerable blood loss, usually representing 25% of the woman’s total blood volume (or approx 1,500 mL or more), has occurred. Thus, earlier recognition of PPH (eg, before deterioration in vital signs) should be the goal in order to improve outcomes. Treatment options for postpartum hemorrhage because of uterine atony include administration of uterotonics or pharmacologic agents, tamponade of the uterus (eg, intrauterine balloons), surgical techniques to control the bleeding (eg, the B-Lynch procedure), embolization of pelvic arteries or, ultimately, hysterectomy. Generally, less invasive methods should be tried initially if possible; however, if unsuccessful, more invasive measures may be required. Uterotonic agents should be the first-line treatment for postpartum hemorrhage caused by uterine atony. Common medical agents (eg, oxytocin, methylergonovine, 15-methyl prostaglandin F2 alpha, and misoprostol). It is common for multiple uterotonic agents to be used, assuming there are no contraindications, and without adequate uterine response and ongoing hemorrhage, they should be used in rapid succession. When uterotonics fail to adequately control postpartum hemorrhage, prompt escalation to other interventions (such as tamponade (JADA or Bakri balloon or surgical techniques) and escalation of intensity of care and support personnel are indicated. #postpartumhemorrhage #laboranddelivery #birth #childbirth #hemorrhage #jadadevice #jada #bakriballoon #greenscreenvideo #greenscreen