WHO guidelines for the management of postpartum haemorrhage (PPH) and retained placenta
came out strongly as an evidence based tool that guides health care providers and policy makers
in ensuring evidenced based practices with respect to management of PPH and retained
placenta.1
It also serves as an empirical evidence to develop national and states protocol s, job aids and
referral system in addressing PPH which will greatly impact on achieving the Millennium
Development Goal 5 of reducing maternal mortality by three – fourth by 2015.
The document is broken down in to relevant sections which each commencing with a research
questions that address particular aspect of PPH management.
The sections are;
1. Diagnosis of PPH
2. Management of atonic PPH
3. Management of retained placenta
4. Choice of fluid for replacement or resuscitation
5. Health systems and organizational interventions
Each of the above named sections commences with at least one research question which the
guideline came up with an answer based on a wide range of consultations with experts in that
field through robust review of literature to find the most reliable evidence of that question and
based on that, recommendations follow suit on a specific management steps in addressing PPH.
The last sections of the document captured the items below
1. PPH care pathways
2. Research implications
3. Plans for local adaptation of the recommendations
4. Plans for supporting implementation of these recommendations
5. GRADE tables
These are also equally important components of the document as they have prompted for more
research where strong evidence is lacking for a particular research question and
recommendations that ensure proper implementation of the document in various settings.