ACE Journal of Gynaecology and Obstetrics
ISSN: OnlineISSN: Print 2520-551X
Abstract
Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality worldwide, accounting for approximately 140,000 deaths annually and representing nearly one‐quarter of all maternal deaths. The evolution from surgical‐dominant approaches toward stepwise conservative management constitutes a paradigm shift in obstetric care with profound implications for maternal survival and fertility preservation. This review provides a comprehensive evaluation of evidence‐based non‐surgical interventions for PPH management, with emphasis on efficacy in reducing maternal mortality while preserving reproductive potential across diverse healthcare settings. systematic literature synthesis was performed using MEDLINE, EMBASE, and the Cochrane Library databases. Studies were included if they reported outcomes of non‐surgical interventions for PPH published between 2000 and 2025, supplemented by landmark earlier trials. Evidence was graded using established hierarchies, prioritizing randomized controlled trials, systematic reviews, and meta‐analyses. The landmark WOMAN trial demonstrated that tranexamic acid (TXA) reduces death due to bleeding by 19‐31% when administered within three hours of birth. Uterine balloon tamponade (UBT) achieves hemostasis in 80‐98% of cases when appropriately applied, with improvised condom‐catheter devices achieving comparable efficacy (88‐96%) at a fraction of the cost (USD 0.64‐6 vs. USD 300‐400 for commercial devices). Uterine artery embolization (UAE) demonstrates success rates exceeding 90‐98% for refractory hemorrhage while preserving fertility in 50–71% of women attempting subsequent conception. The E‐MOTIVE protocol, incorporating early detection and bundled first‐line interventions, reduces severe PPH and maternal death by 60% compared to standard care.Universal implementation of evidence‐based non‐surgical interventions—organized within standardized care bundles—can transform PPH from a leading cause of maternal death to a manageable complication. Addressing the persistent disparity in PPH outcomes between high‐resource and low‐resource settings requires contextappropriate strategies, sustained training, and health systems investment.
How to cite this article:
Azhar Imran Ibrahim Baquba and Sally Najem Obaid. Non‐Surgical Management of Postpartum Hemorrhage: A Comprehensive Review of Evidence‐Based Interventions.
DOI: https://doi.org/10.36478/.36478/acejgo.2026.1.1.4
URL: https://www.makhillpublications.co/view-article/2520-551X/.36478/acejgo.2026.1.1.4