الفهرس 
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Abstract
Primary PPH is genital tract bleeding more than 500 ml for a vaginal delivery and 1,000 ml for a caesarean birth within 24 hours of the birth of a baby. It is a leading cause of maternal mortality in developing countries. Uterine atony alone accounts for 75–90% of cases of postpartum hemorrhage. There is a wide variation of PPH incidence across the different regions of the world, ranging from 10.45% in Africa to 6.38% in Europe. Prevention of PPH should include antenatal care that assures that anaemia or other health problems are treated as well as active management of the third stage of labour. The management of PPH may be considered as having at least four components: communication with all relevant professionals; resuscitation; monitoring and investigation; measures to arrest the bleeding. These components must be initiated and progressed simultaneously for optimal patient care. As uterine atony is the cause of the bleeding, uterotonic drugs are a crucial aspect of treatment of PPH. Also, massage of the uterusshould and bimanaual compression be applied. If medical measures fail to control haemorrhage, initiate surgical haemostasis sooner rather than later. Application of NASG, intrauterine balloon tamponade is an appropriate first line ‘surgical’ intervention. If this fails, these interventions may be attempted: haemostatic brace suturing (B-Lynch sutures or its modification), bilateral ligation of uterine ,internal iliac arteries and selective arterial embolisation. Subtotal or total abdominal hysterectomy should be attempted as the last resort to save life.