Postpartum Hemorrhage – Still a conundrum?

Postpartum hemorrhage (PPH) is a major cause of morbimortality in low-income regions, being characterized by blood losses either during the physiological postpartum (≥ 500 ml) or in the immediate postpartum (≥ 1000 ml), and causing variable degrees of hemodynamic instability. Although a preventable condition, PPHs may be involved in one-fourth of all maternal deaths; then, the risk assessment must be utilized to identify pregnancies with more possibility of a PPH. Imaging studies can predict the PPHs in patients with the diagnosis of placenta previa, but the risk factors due to parity or duration of the second and third stages of labor are less understood. Optimizing the safety related to PPH needs consensual guidelines for healthcare and monitoring, besides prompt adequate, and timely interventions; but this is still lacking for vaginal deliveries. The aim is to emphasize the recent article published in this Journal focusing on PPH in Ecuador.