Management of Obstetric Postpartum Haemorrhage: a UK national audit of practice

Status: Published

Published in Risk Management and Healthcare Policy in January 2017

Postpartum haemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity.  To assess the current practice in the UK, we conducted a national multicentre prospective audit over one calendar month (September-October 2014) against national guidelines.  We collected data on patients’ demographics, the incidence of PPH, prophylaxis and management measures, estimated blood loss, the onset of labour and mode of delivery.

Data was collected by 197 specialty trainees from 98 maternity units in the UK. We captured 3635 cases of primary postpartum haemorrhage. The majority of cases were mild to moderate PPH (92%).  Prophylactic agents were given in 97% of cases, most commonly using Syntometrine.  The most frequently utilised additional uterotonic agent was Syntocinon IV (32%).  There was poot senior involvement in the management of PPH, from both consultant obstetricians and anaesthetists. 

Our audit demonstrates evidence of wide variations in practice for preventing and managing primary post partum haemorrhage across maternity units in the UK compared to national guidelines.  Interventions are needed to improve the quality of maternity care in this field.

Publication Reference

Wattar B, Tamblyn J, Parry-Smith W, Prior M, Van Der Nelson H. Management of obstetric postpartum haemorrhage: a national service evaluation of current practice in the UK. Risk Management and Healthcare Policy 2017, 10: p.1-6.