Re: [ozmidwifery] PPH

[Jenny Cameron]

Hello Monica   As far as I know WHO call >500ml a PPH. They acknowledge that 1000mls is probably manageable physiologically in a healthy woman but their policy statements are global and the 500 mls is to take into account the many anaemic women in the world. Brucker (2001) states that the average woman loses < 500 mls in third stage. My own experience would agree with this.   1000 mls is a considerable amount to lose, even for a healthy woman. It is a matter of knowing the woman's Hb prior to birth and if she is healthy and of average height and weight with a good Hb; 12  or above, she probably can withstand up to a litre, certainly 800 mls without going into shock. O.K. she won't go into shock but a big fluid loss could mean she will be slow to establish a good breastmilk supply or she may take a while to recover postbirth.   A few thoughts. Hope it is helpful.   Brucker, M. 2001. Management of the third stage of labour: an evidence-based approach, Journal of Midwifery and Women's Health. Vol 46:6.   Jenny Jennifer Cameron FRCNA FACM PO Box 1465 Howard Springs NT 0835   0419 528 717 ----- Original Message ----- From: Michelle Windsor To: ozmidwifery@acegraphics.com.au Sent: Saturday, March 19, 2005 3:01 PM Subject: Re: [ozmidwifery] PPH Hi Monica,   In the WHO guide to care in childbirth it says is that up to 1000 ml blood loss may be physiological in healthy populations.  This WHO guide was published in 1997 I think, and I haven't yet seen a more recent edition.  You can purchase it through Birth International (www.birthinternational.com.au )  Hope this helps.   Cheers Michelle mh <[EMAIL PROTECTED]> wrote: Hi all, I sent this yesterday but it didn't come through to me at least so apologies if it's a repeat. There were some references a while ago about the WHO defininition of a PPH as being over 1000 mls. As we are now being required to go the most extreme lengths to treat "PPHs" of 500mls or more, even if not causing any symptoms and bleeding is settling, I would love some evidence to suggest this is overkill. Can anyone point me to the WHO document? Thanks, Monica -- This mailing list is sponsored by ACE Graphics. Visit to subscribe or unsubscribe. Find local movie times and trailers on Yahoo! Movies.