{
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  "id": "maternal:postpartum-hemorrhage",
  "owner": "maternal",
  "kind": "condition",
  "slug": "postpartum-hemorrhage",
  "name": "Postpartum haemorrhage",
  "aliases": [
    "Postpartum hemorrhage",
    "PPH"
  ],
  "atlases": [
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  ],
  "summary_plain": "Heavy bleeding after a baby is born. It is one of the most common complications of childbirth. It is also a leading cause of death for mothers worldwide, and most of those deaths happen in low- and middle-income countries.",
  "summary_technical": "Two definitions appear in this atlas and each belongs to its source. WOMAN let hospitals treat a woman as having PPH on a clinical diagnosis, based on estimated blood loss of more than 500 mL after vaginal birth or 1000 mL after caesarean section, or any loss that compromised haemodynamic stability. That is the trial eligibility wording, not WHO wording. WHO 2025 Recommendation 22 gives a \"therapeutic definition\" meant to start treatment, built on objectively measured blood loss: 300 mL or more with any abnormal haemodynamic sign, or 500 mL or more, whichever occurs first within 24 hours after birth. The older rule of thumb is a loss of more than 500 mL within 24 hours. The two burden figures from WHO (2023 and 2025) have different bases and are kept as separate claims.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-11",
  "last_evidence_check": "2026-10-11",
  "next_review_due": null,
  "external_ids": [],
  "navigation": {
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      "life-stage": [
        "childbirth",
        "postpartum"
      ]
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  },
  "payload": {
    "taxonomy_codes": [],
    "recognition": "Bleeding is often noticed late when blood loss is judged by eye. WHO says visual estimation is frequently inaccurate and recommends measuring blood loss objectively (Recommendation 21).",
    "assessment": "WHO 2025 Recommendation 22 uses objectively measured loss of 300 mL or more with any abnormal haemodynamic sign (pulse above 100 beats a minute, shock index above 1, systolic pressure below 100 mmHg or diastolic pressure below 60 mmHg), or 500 mL or more, whichever occurs first within 24 hours after birth, with particular vigilance during the first 2 hours.",
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      "id": "maternal:claim-who-2023-burden",
      "owner": "maternal",
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      "category": "burden",
      "statement": "WHO's 2023 recommendations say there were an estimated 287 000 maternal deaths worldwide in 2020, most of them in the world's least developed countries. WHO says obstetric haemorrhage is the leading cause of maternal mortality, accounting for 27% of all maternal deaths occurring worldwide each year, and that most of these deaths are due to postpartum haemorrhage. WHO estimates that about 14 million women experience PPH each year.",
      "context": {
        "id": "maternal:ctx-global-maternal-deaths-2020",
        "label": "Maternal deaths worldwide in 2020 and women who experience postpartum haemorrhage each year (WHO 2023 estimates)",
        "recipient": "maternal",
        "population": "Women who died of maternal causes worldwide (2020 estimate) and women who experience postpartum haemorrhage each year (WHO estimate).",
        "care_setting": "Not stated in the source",
        "geography": "Worldwide. WHO says most deaths occurred in the world least developed countries.",
        "life_stage": "Pregnancy, childbirth and the postpartum period",
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not applicable (burden estimate)",
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            "Maternal deaths and PPH episodes, as counted in the WHO estimates"
          ],
          "exclusion": []
        }
      },
      "evidence_stage": "synthesis",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "These are WHO estimates in an executive summary, not counts. The 27% is a share for obstetric haemorrhage as a whole, and the passage dates only the 287 000 figure to 2020. The 2025 WHO statement that PPH accounts for nearly one fifth of all maternal deaths has a different basis and is a separate claim. The two figures are not combined or reconciled. The sources WHO cites were not read.",
      "editorial_state": "draft",
      "checked_at": "2026-10-11",
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          "locator": "Executive summary, Introduction, para 1",
          "applicability_note": "WHO 2023 recommendations, CC BY-NC-SA 3.0 IGO; short quotation with attribution.",
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            "publication_date": "2023-12-21",
            "publisher": "World Health Organization",
            "edition": "2023. History and burden figures only: WHO integrated Recommendations 1 and 2 of this document into its 2025 consolidated guideline unchanged, as Recommendations 21 and 29, so the 2025 document carries the current decisions.",
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      "id": "maternal:claim-who-2025-burden",
      "owner": "maternal",
      "subject_entity_id": "maternal:postpartum-hemorrhage",
      "category": "burden",
      "statement": "WHO's 2025 consolidated guideline says postpartum haemorrhage accounts for nearly one fifth of all maternal deaths worldwide and is the main cause of maternal death in most low-income countries. It says about 80% of related deaths occur in low- and middle-income countries, particularly in sub-Saharan Africa and South Asia.",
      "context": {
        "id": "maternal:ctx-global-maternal-deaths-who-2025",
        "label": "Maternal deaths worldwide and postpartum haemorrhage (WHO 2025 consolidated guideline)",
        "recipient": "maternal",
        "population": "Maternal deaths worldwide, with the share attributed to postpartum haemorrhage, and the share of related deaths in low- and middle-income countries.",
        "care_setting": "Not stated in the source",
        "geography": "Worldwide, with a focus on low- and middle-income countries, particularly in sub-Saharan Africa and South Asia.",
        "life_stage": "Pregnancy, childbirth and the postpartum period",
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not applicable (burden statement). The 2025 text gives no year for its figures.",
        "eligibility": {
          "inclusion": [
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          ],
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      "evidence_stage": "synthesis",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "The 2025 text gives no year for these figures and cites a reference that was not read. The 2023 WHO figure (obstetric haemorrhage as 27% of maternal deaths) has a different basis and is a separate claim. The two are not combined or reconciled.",
      "editorial_state": "draft",
      "checked_at": "2026-10-11",
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          "source": {
            "id": "maternal:who-2025-pph-consolidated",
            "source_type": "guideline",
            "title": "Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage",
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            "publication_date": "2025-10-05",
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          "locator": "Introduction, para 4: about 80% of related deaths in low- and middle-income countries",
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