Postpartum hemorrhage is a leading cause of maternal morbidity and mortality, particularly in developing countries like Nepal. Early identification of women at risk is vital but traditional methods are sometimes subjective. Simple objective tools are of high importance in times of need. This study aimed to evaluate and compare the predictive performance of the Shock Index and Modified Shock Index for adverse maternal outcomes after primary postpartum hemorrhage. A hospital based cross sectional study was conducted at a tertiary maternity hospital in Nepal. The study included 281 women diagnosed with primary postpartum hemorrhage. Heart rate, systolic blood pressure and mean arterial pressure were recorded at 1 and 2 hours postpartum. Shock Index and MSI were calculated. The adverse maternal outcomes such as including blood transfusion, surgical interventions or intensive care unit admissions were analyzed. The predictive ability of Shock Index and Modified Shock Index was analyzed using Receiver Operating Characteristic curve analysis. Both Shock Index and Modified Shock Index were significant predictors of adverse maternal outcomes. The single best predictor was identified as Shock Index as measured at 1 hour in women who underwent cesarean delivery, with an Area Under the Curve of 0.811 (95% CI: 0.754-0.868). For vaginal deliveries at 1 hour, Shock Index and Modified Shock Index performed similarly (Area Under Curve 0.777 and 0.776, respectively). Predictive ability decreased at the 2 hour mark, especially for patients post-cesarean delivery. Logistic regression confirmed that cesarean delivery and Shock Index at 1 hour were strong and independent predictors of the adverse outcomes. The Shock Index is a simple and effective tool for the early detection of increased risk of adverse outcomes from postpartum hemorrhage. Modified Shock Index in particular showed greater overall predictability. Its routine implementation in postpartum monitoring, primarily in low-resource settings can significantly aid the triage and facilitate early life saving interventions.

Postpartum hemorrhage is a well-recognized and potentially life-threatening complication in both animals and humans. This case report describes a primary postpartum hemorrhage in a second parity sow managed in a free-farrowing system with the support of telemedicine. A 16 months old Large White sow showed severe hemorrhagic vaginal discharge after the farrowing process. A thorough case history and visual examination of the animal were conducted using telemedical technique prior to treatment. Farrowing began at 14:00 on a Saturday without hormonal induction, and the sow delivered eight live-born piglets by 16:30 without intervention. Overnight, no observations were made. At 04:30 the following morning, the sow was found with nine live-born piglets and one stillborn. During morning feeding, the farmer observed a large amount of blood on the pen walls and severe hemorrhagic vaginal discharge and contacted the veterinarian, initiating a telemedical consultation. Examination revealed a normal appetite, a body temperature of 38.4 °C, firm faeces without visible blood, and no external injuries to the tail, vulva, or vagina. No signs of ongoing labour were observed. Manual palpation of the birth canal was avoided due to the severity of bleeding. Transabdominal ultrasonography revealed no presence of retained piglets. Telemedical evaluation indicated pallor, and the final diagnosis of uterine bleeding was made. Intramuscular administration of 30 IU oxytocin was recommended to stimulate uterine contractions and control the hemorrhage. During the follow up consultation one hour later, the farmer reported that the bloody vaginal discharge stopped within 15 min after oxytocin administration. This case documents primary postpartum hemorrhage in a free-farrowing sow, a condition not previously reported in the literature. It also illustrates the value of telemedicine in porcine health management, enabling timely assessment and intervention in life-threatening situations.

This study investigated the clinical characteristics and referral outcomes of primary postpartum hemorrhage cases. All the postpartum hemorrhage referral cases were analyzed and divided into two groups based on blood loss: < 2500 ml and ≥ 2500 ml. Clinical features, complications, and treatments were compared. Patients with blood loss ≥ 2500 ml had significantly higher incidences of disseminated intravascular coagulation, organ dysfunction, intensive care unit admission, and longer hospital stays. Birth canal laceration was more frequently the cause of bleeding in this group (P<0.05). More aggressive interventions before referral, including uterine tamponade, B-Lynch sutures, pelvic vascular ligation, and hysterectomy, were required in the ≥ 2500 ml group (P<0.05), along with significantly greater blood product transfusion. Increasing postpartum blood loss was associated with worse maternal outcomes and higher treatment intensity. These findings emphasize the importance of early active management of postpartum hemorrhage and timely referral once the patient’s condition is stabilized to improve prognosis.

There is a scarcity of literature documenting how women facing maternal morbidity issues deal with challenges to breastfeeding. This case study documents challenges faced by two women, one who underwent major abdominal surgery immediately after a Caesarean section at 32 weeks, and the other who had a primary and secondary postpartum hemorrhage with repeated hospital admissions. In the first case, the key issues for lactation were the mother-infant separation and difficulty in initiation and sustaining breastfeeding due to abdominal surgery after her Caesarean section. Early and frequent removal of milk are critical for establishing and sustaining supply and were challenging for the mother in the intensive care unit for 3 weeks. The second case involved a mother experiencing severe postpartum hemorrhage. Having lost over 3 L of blood, this mother faced a significant risk of a reduction in prolactin and activation of her milk supply. Her subsequent weakness and dyspnoea due to anaemia meant breastfeeding required extraordinary effort. Establishing lactation under these circumstances was challenging. Both mothers needed guidance and encouragement to build up and maintain their supply and the practical support of family to care for the infant. In Case Study 1, donor milk was used and alternated with artificial breastmilk substitutes until the mother re-established her supply after discharge. In Case Study 2, the mother required help to express, position, and hold the baby while she breastfed. Despite overwhelming medical and physiological odds, it is possible to establish exclusive breastfeeding with consistent personalized health-system support/training and relentless determination.

Background: Postpartum hemorrhage is a major cause of maternal morbidity and mortality, particularly in vaginal delivery, with uterine atony as the most common etiology. Therefore, the administration of uterotonic agents during the third stage of labor plays an important role in preventing postpartum hemorrhage. Methylergometrine is still widely used; however, data regarding its effect on the severity of postpartum hemorrhage in Indonesia remain limited. Purpose: To compare the severity of postpartum hemorrhage among women with normal vaginal delivery who received and did not receive methylergometrine at RSUD Dr. Moewardi Surakarta. Method: This study was an observational analytic study with a retrospective cohort design using secondary data from medical records. A total of 92 women with normal vaginal delivery who experienced primary postpartum hemorrhage during the period 2022–2024 were included and divided into groups receiving and not receiving methylergometrine. The severity of postpartum hemorrhage was classified into mild–moderate and severe. Data were analyzed using univariate and bivariate analyses with the Fisher’s exact test at a significance level of p &lt; 0.05. Results: All women who received methylergometrine experienced mild–moderate postpartum hemorrhage, whereas 9.5% of severe postpartum hemorrhage cases were found in the group that did not receive methylergometrine. There was a significant association between methylergometrine administration and the severity of postpartum hemorrhage (p = 0.026), with an odds ratio of 0.905 (95% CI: 0.820–0.998). Conclusion: Methylergometrine administration was significantly associated with a reduced severity of postpartum hemorrhage in women with normal vaginal delivery.

Uterine compression sutures have proven to be a valuable and safe option in the control of Postpartum hemorrhage. To avoid complications related to uterine compression sutures (uterine necrosis, synechia, and pyometra), we assess the efficacy of removable uterine compression suture (RUCS) for primary postpartum hemorrhage (PPH) and evaluate its effectiveness. This retrospective preliminary study was conducted at a tertiary referral hospital between January 2020 and November 2024, including patients diagnosed with postpartum hemorrhage who required compression sutures. Demographic characteristics of the patients who underwent RUCS and postpartum clinical parameters were determined. Bleeding was successfully controlled in all 11 patients (100%). A mild, localized ecchymosis occurred at the unilateral suture exit site and resolved spontaneously. No intrauterine synechiae were detected in any of the 11 patients at 6-month hysteroscopic evaluation. Fertility outcomes were available for six women, five of whom achieved subsequent pregnancies. In this study, we present a novel removable compression suture that appears to be effective, simple, and rapid in application, with the potential to reduce serious complications; however, further evaluation is warranted.

Predictors of primary postpartum hemorrhage among middle eastern postpartum women with vaginal delivery: A retrospective matched case-control study.

Background: Primary postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, particularly in developing countries. Early identification of clinicodemographic risk factors is essential for prevention and improved maternal outcomes. Objective: To assess the clinicodemographic risk factors and maternal outcomes associated with primary postpartum hemorrhage in a tertiary care hospital. Methods: This prospective observational study included 100 women who developed primary PPH within the first 24 hours after delivery. Primary PPH was defined according to World Health Organization criteria. A structured proforma was used to document sociodemographic characteristics, obstetric risk factors, causes of PPH, and maternal outcomes. Data were analyzed using SPSS version 26. Chi-square or Fisher’s exact tests were applied to evaluate associations between risk factors and adverse maternal outcomes, with a p-value &lt;0.05 considered statistically significant. Results: The mean maternal age was 29.4 years. Major risk factors identified were multiparity (62%), anemia (61%), and rural residence (65%). Cesarean delivery accounted for 44% of cases. Uterine atony was the most common cause of PPH, responsible for 72% of cases. Maternal outcomes included the need for blood transfusion (68%), surgical intervention (19%), ICU admission (15%), and hysterectomy (4%). Maternal mortality was reported in 2% of cases. Anemia, multiparity, cesarean delivery, and prolonged labor showed significant associations with severe maternal outcomes (p ≤ 0.05). Conclusion: Primary postpartum hemorrhage is strongly associated with modifiable clinicodemographic factors, particularly anemia, multiparity, and inadequate prenatal care. Early risk stratification, correction of maternal hemoglobin levels, and timely obstetric intervention are crucial to reducing severe morbidity and mortality. Strengthening antenatal care and ensuring optimal emergency obstetric preparedness remain key strategies for improving maternal health outcomes.

Background: Postpartum haemorrhage (PPH) is the major cause of maternal death worldwide, significantly in poor countries, like Asia, Africa. In our country PPH is the major cause of maternal mortality (about 80%). Global studies for decades showed that maternal mortality following PPH is due to uterine atony following vaginal delivery, caesarean section delivery and use of uterotonic drugs are the choice for both prevention and treatment of PPH. This study aims to evaluate the use and efficacy of intrauterine misoprostol versus oxytocin alone, in controlling postpartum haemorrhage due to atonic uterus amongst women with undergone Caesarean section in a tertiary care hospital setting of Bangladesh. Material and Methods: This randomized clinical trial was done in the Department of Obstetrics &amp; Gynecology, Eastern Medical college Hospital, Cumilla, Bangladesh between January 2022 to December 2022. A total of 100 participants were randomly selected from all patients who admitted for elective cesarean section within this period. In this, the study group (Group A=50), received only intrauterine misoprostol after placental delivery. On the other hand, in control group (Group B=50) received routine intravenous Oxytocin alone. Results: There were no significant differences in baseline characteristics between the two groups. Group A (misoprostol) showed significantly lower preoperative, post-operative, and total blood loss compared to Group B (oxytocin). Post-operative hemoglobin and hematocrit levels were significantly higher in Group A (p&lt;0.01 and p&lt;0.001, respectively). Additionally, Group A required fewer additional uterotonics and had a lower incidence of side effects, with no major differences in the type of adverse effects between the groups. Conclusion: This study concluded that intrauterine misoprostol is more effective than intravenous oxytocin in reducing blood loss and maintaining better postoperative hemoglobin and hematocrit levels during cesarean section, with fewer additional uterotonic requirements and minimal side effects. Eastern Med Coll J. July 2025; 10 (2): 111-115

Introduction: Primary PPH is a leading cause of maternal mortality, and maternal factors such as anemia and nutritional status measured by Body Mass Index (BMI) may influence its occurrence. However, existing evidence on the association between these factors and primary PPH remains inconsistent. Objective: This study aimed to analyze the relationship between BMI and anemia during pregnancy and the incidence of primary postpartum hemorrhage at RSUD Blambangan Banyuwangi. Methods: A retrospective case–control design was used involving 120 postpartum women, comprising 60 cases of primary PPH and 60 controls without PPH. Total sampling was applied using medical records from January to December 2024. Data analysis employed the Chi-Square test, and risk estimates were calculated using Odds Ratios (OR). Results and Discussion: The major causes of primary PPH included uterine atony (43.34%), cervical rupture (28.33%), retained placenta (20%), and perineal rupture (8.33%). Anemia showed a significant association with primary PPH (p = 0.001; OR = 3.455), indicating that anemic pregnant women had a 3.4-fold increased risk of experiencing PPH. Conversely, BMI did not demonstrate a significant relationship with PPH, suggesting that nutritional status may play a lesser role compared to hematological factors. Conclusions: Anemia during pregnancy is significantly associated with primary PPH, whereas BMI shows no significant association. Enhanced antenatal screening and effective management of anemia are essential for reducing the risk of PPH.

Background Adolescent pregnancy remains a significant public health concern in low- and middle-income countries, contributing substantially to maternal and perinatal morbidity and mortality. Understanding its burden and outcomes is crucial for improving care and guiding interventions.  Objective To determine the burden and delivery outcomes among adolescent mothers managed at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, over a 5-year period, and to compare these outcomes with those of older mothers.  Methods A retrospective review of delivery records at EKSUTH from 2020 to 2025 was conducted. Data were extracted from the labour ward register and analyzed with SPSS using descriptive and comparative statistics. Adolescent mothers were defined as those aged 10–19 years. Variables included sociodemographic characteristics, obstetric profile, mode of delivery, maternal complication, and perinatal outcomes such as birth weight, gestational age, APGAR scores, and stillbirths. Statistical significance was set at p &lt; 0.05.  Results Of 5,731 deliveries during the study period, 5,613 (97.9%) had complete data for analysis out of which Eighty-five (1.5%) were adolescent mothers. Most adolescents were primigravidae (83.5%), nulliparous (91.8%), and unbooked (64.7%). Vaginal delivery was the predominant mode of delivery (65.9%). Primary postpartum hemorrhage occurred in 3.5% of cases, with one maternal death recorded accounting for 1.18%. The mean birth weight of babies of adolescent mothers was 2.69kg with stillbirths occurring in 8.2% of the deliveries. Although neonatal mortality was almost twice as high in adolescent mothers (4.2%), the difference did not reach statistical significance. The maternal outcomes were comparable. Twin gestations represented 3.5% of cases, and no triplets were recorded.  Conclusion Adolescent pregnancies at EKSUTH constitute a small but important proportion of deliveries, with generally favorable maternal but poorer perinatal outcomes. Strengthening adolescent reproductive health education, improving antenatal care access, and providing adolescent-friendly obstetric services are essential to mitigate these risks and enhance outcomes.

Primary postpartum hemorrhage (PPH) remains a major contributor to maternal morbidity and mortality in resource-limited settings. In this case-control study of 318 women delivering vaginally at public hospitals in Lusaka, Zambia, prolonged third stage of labor and specific intrapartum complications were independently associated with primary PPH. Duration of the third stage of labor was associated with increased odds of PPH (adjusted odds ratio [aOR] 1.1, 95% CI 1.05 - 1.46, P = 0.048). Uterine atony (aOR 7.4, 95% CI 4.5 - 14.6, P < 0.0001) and cervical tears (aOR 11.3, 95% CI 7.9 - 21.7, P < 0.0001) were strongly associated with PPH. Retained placenta was also an independent predictor (aOR 4.3, 95% CI 3.4 - 9.7, P = 0.001). Socio-demographic factors showed no meaningful association with PPH after multivariable adjustment. Secondary outcomes observed among cases included hemorrhagic shock, hysterectomy, ICU admission, and maternal death. These results emphasize early recognition and prevention of modifiable intrapartum risk factors to reduce PPH-related morbidity and mortality.

Obstetric haemorrhage—particularly primary postpartum haemorrhage—remains the leading preventable cause of maternal death worldwide. Despite pharmacological and surgical advances, its incidence remains high in low- and middle-income countries, where limited access to high-quality uterotonics, safe blood products, and multidisciplinary teams increases lethality. This article critically reviews the epidemiology, pathophysiology, and contemporary evidence-based diagnostic and treatment strategies published between 2000 and 2025. The Shock Index (≥ 0.9) is highlighted as an early marker of haemodynamic instability, and the importance of objective blood-loss quantification for activating rapid-response protocols is emphasised. Stepwise management integrates early haemostatic resuscitation, sequential and rational use of uterotonics, administration of tranexamic acid within the first three hours, intra-uterine tamponade, conservative surgical techniques, and—where available—selective arterial embolisation. A prevention bundle centred on active management of the third stage of labour with oxytocin or heat-stable carbetocin reduces postpartum haemorrhage incidence by more than 40 %. Disparities between high- and low-income countries demand systemic interventions that ensure supplies, train personnel, and optimise referral networks. Implementation of standardised obstetric bundles, together with wider availability of haemostatic technologies and universal access to heat-stable uterotonics, constitutes the most effective strategy for achieving the Sustainable Development Goal 2030 targets for maternal-mortality reduction.

A Randomised Controlled Study on the Effectiveness of Oral versus Rectal Misoprostol as Adjunct for Prevention of Primary Postpartum Haemorrhage at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria

BACKGROUND AND OBJECTIVE: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide. When pharmacologic measures fail, surgical alternatives are required. This study aimed to compare the efficacy and safety of intrauterine packing (IUP) and balloon tamponade (BT) in achieving hemostasis in PPH due to uterine atony. METHODOLOGY: A randomized controlled trial (ClinicalTrials.gov ID: NCT05234578) was conducted at MNCH Hospital, Faisalabad. A total of 220 women aged 18–40 years with primary PPH due to uterine atony were randomized into two groups: Group A (IUP) and Group B (BT). Outcomes included success in achieving hemostasis, complication rates, and blood loss. RESULTS: Mean age and estimated blood loss were comparable between groups (p &gt; 0.05). Although BT had a higher success rate (97.3%) than IUP (91.8%), the difference was not statistically significant (p = 0.135, Fisher’s Exact Test). Perforation occurred more frequently in the IUP group (5.5%) than the BT group (0.9%), but this was also not significant (p = 0.119). Fever and hysterectomy rates showed no significant differences (p &gt; 0.05). CONCLUSION: Although BT showed trends toward greater efficacy and fewer complications than IUP, these differences were not statistically significant. However, due to its minimally invasive nature and favorable safety profile, BT may be considered a preferred option for managing PPH due to uterine atony. Further large-scale studies are warranted.

Pregnant persons with bleeding disorders (pwBD) have an increased risk of primary and secondary postpartum hemorrhage (PPH). Patients with von Willebrand disease, a bleeding disorder of unknown cause, or qualitative platelet defects (QPDs) and hemophilia carriers (HC) may or may not naturally achieve an adequately hemostatic state due to the hypercoagulable changes of pregnancy. PwBD greatly benefit from receiving care in a multidisciplinary setting including hematologists, obstetricians, anesthesiologists, and clinical geneticists. Factor levels should be obtained, at minimum, prior to conception as baseline as well as at the 34- to 36-week mark for delivery planning. However, target factor levels for delivery remain controversial given that many bleeding phenotypes do not predictably correlate with levels. Hemostatic therapies include antifibrinolytic agents, desmopressin, factor concentrates, and blood components such as cryoprecipitate, plasma, and platelets. Antifibrinolytics such as tranexamic acid have the most robust evidence for PPH management, though factor concentrates are now routinely utilized in certain circumstances. Blood products are an option for pwBD who have QPDs or when factor concentrates are not available. In patients with certain bleeding disorders, such as HCs, mode-of-delivery discussions must include consideration of the risks both to the affected neonate and to the mother. We favor selecting the mode of delivery based upon maternal indications whenever possible. Post partum, therapies may be continued for days or sometimes weeks after delivery, as pwBD are at high risk for delayed PPH.

Background: Postpartum hemorrhage (PPH) is an obstetric emergency that causes almost 25% of deaths among pregnant ladies every year globally.Objective: To determine the frequency of primary postpartum hemorrhage and its risk factors in Hayatabad Medical Complex Peshawar.Methodology: It was a descriptive study that was held at Department of Gynecology &amp; Obstetrics, Hayatabad Medical Complex, Peshawar, Pakistan which enrolled 162 patients through non-probability consecutive sampling. After informed consent, history was taken, and physical examination was done. Demographic details of all patients were documented. All female patients in spontaneous labour reporting in emergency with a single, alive, healthy, full term (≥ 37 weeks) pregnancy with parity up to 7 were enrolled. Patients who had blood loss more than 500 ml in spontaneous vaginal delivery (SVD) and ≥ 1000 ml in cesarean section were taken as postpartum hemorrhage. All the data was processed by SPSS v26.0. Quantitative variables were presented as mean ± SD. Qualitative variables were presented in terms of frequencies and percentages. Post-stratification, chi-square test was applied taking p-value ≤ 0.05 as significant.Results: Mean age of patients with PPH was 31.44 ± 5.7 years. PPH was seen in 32.1% (n=52) cases among enrolled patients (n=162). PPH when stratified for gestational age and maternal age showed insignificant p-value ≥ 0.05. PPH when stratified with mode of delivery showed significant difference with p-value of 0.018.Conclusion: The study concluded that postpartum hemorrhage occurs with high frequency in the studied Pakistani population. Moreover, PPH is more common following spontaneous vaginal delivery and is associated with uterine atony, which remained the most frequent underlying cause.

Postpartum hemorrhage is a significant barrier to the achievement of Sustainable development goal 3.1, given that it is associated with more than a quarter of all maternal mortality cases. Traditional birth attendants (TBAs), who are outlawed in many countries, including Uganda inclusive, attend to about 33% of all births globally. The objective of this study was to explore the management practices of primary postpartum hemorrhage among traditional birth attendants in Iganga district. The study used a case phenomenological qualitative exploratory design, targeting traditional birth attendants. Snowballing was used to select participants and engage them in-depth interviews. Data collected was analyzed thematically, with the induction approach. It was found that TBAs carried out PPH assessment using three methods; quantification of blood lost using household cups, vital assessment and visual assessment. Visual assessment was the most dominant. Postpartum hemorrhage resuscitation practices mainly rotated around the use of warm water. They did not carry resuscitation. The treatment interventions used were: use of herbal medicine and referral of severe cases to hospital. TBAs in Iganga district visually assess postpartum hemorrhage but they do not conduct resuscitation procedures. They use herbal uterotonics in the treatment of postpartum hemorrhage alongside with referral to hospital.

To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized. A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50 % in the composite maternal hemorrhage-related maternal morbidity (35-53 % absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80 % power with a p < 0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity. From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, 0.28 % of deliveries, 95 % confidence interval (CI) 0.21-0.35 %. The composite hemorrhage-related maternal morbidity was increased in individuals with secondary compared to primary postpartum hemorrhage, adjusted odds ratio (OR) 14.0, 95 % CI 4.6 to 42.2. Most individuals with secondary postpartum hemorrhage had a dilation and curettage 91.5 % (86/94). In individuals with secondary postpartum hemorrhage that underwent uterine evacuation, histology revealed 45.2 % (38/84) had retained placenta, and 20.2 % (17/84) subinvolution. A composite maternal hemorrhage-related outcome is associated more often with secondary compared to primary postpartum hemorrhage and nearly all individuals with secondary postpartum hemorrhage undergo a dilation and curettage.

Background: Postpartum haemorrhage (PPH) remains a major cause of maternal morbidity and mortality, particularly in low-resource settings. Early identification of risk factors and timely intervention are essential to improving outcomes. This study investigates the aetiologies, risk factors, management patterns, and outcomes of PPH in a tertiary care centre. Methods: A prospective observational study was conducted on 80 cases of PPH among 14, 442 deliveries between August 2022 and July 2024. Detailed clinical assessment, quantification of blood loss, laboratory evaluation, and management according to institutional protocols were undertaken. The findings were compared with established national and international literature. Results: Primary PPH accounted for 92.5% of cases. Emergency or referred admissions constituted 80%, while 20% were registered patients. Most affected women were aged 25-30 years (50%). Uterine atony was the predominant cause (64.86%), followed by traumatic PPH (27.02%). Significant risk factors included previous caesarean section (25%), multigravidity (16.66%), placenta previa (12.5%), anaemia (14.5%), preeclampsia (8.3%), and placental abruption (8.3%). Medical management alone was effective in 32.5% of atonic PPH cases, primarily using oxytocin and misoprostol; uterine tamponade was used in selected cases. Surgical intervention was required in 67.5% of cases, including uterine artery ligation, internal iliac ligation, repair of genital tract injuries, manual removal of placenta, and one hysterectomy. Postoperative complications occurred in 18 patients. Maternal mortality was 2.5%, with deaths due to acute renal failure with DIC and dilated cardiomyopathy. Blood component therapy was required in most patients. Conclusion: PPH is a preventable emergency requiring rapid recognition, coordinated multidisciplinary care, and access to effective medical and surgical interventions. Strengthening antenatal care and emergency referral systems can significantly reduce PPH-related maternal morbidity and mortality.