Outline the causes and management of severe postpartum haemorrhage (PPH).
This question is identical to Question 17 from the second paper of 2018, and is almost identical to the very similarly structured Question 3 from the second paper of 2020. Why they went back to the 2018 format is a mystery.
Causes of PPH
It is not possible to add much to the (already comprehensive) list of causes offered by the model answer.
Management of PPH
This structure and a lot of the components are borrowed from the RANZCOG statement C-Obs 43.
Oh's Manual, Chapter 64 ("General obstetric emergencies") by Winnie TP Wan and Tony Gin, p. 684
Mousa, Hatem A., et al. "Treatment for primary postpartum haemorrhage." The Cochrane Library (2014).
Tunçalp, Özge, G. Justus "Prostaglandins for preventing postpartum haemorrhage."Hofmeyr, and A. Metin Gülmezoglu. "Prostaglandins for preventing postpartum haemorrhage." Cochrane Database Syst Rev 8.8 (2012): CD000494.
Alfirevic, Zarko, et al. "Use of recombinant activated factor VII in primary postpartum hemorrhage: the Northern European registry 2000–2004." Obstetrics & Gynecology 110.6 (2007): 1270-1278.
Dahlke, Joshua D., et al. "Prevention and management of postpartum hemorrhage: a comparison of 4 national guidelines." American journal of obstetrics and gynecology 213.1 (2015): 76-e1.
Doumouchtsis, S. K., et al. "Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review." BJOG: An International Journal of Obstetrics & Gynaecology 121.4 (2014): 382-388.
Smith, J., and H. A. Mousa. "Peripartum hysterectomy for primary postpartum haemorrhage: incidence and maternal morbidity." Journal of obstetrics and gynaecology 27.1 (2007): 44-47.
World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization, 2012.
Weeks, A. "The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?." BJOG: An International Journal of Obstetrics & Gynaecology122.2 (2015): 202-210.
Sheiner, Eyal, et al. "Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study." The Journal of Maternal-Fetal & Neonatal Medicine 18.3 (2005): 149-154.
Mousa, Hatem A., and Steven Walkinshaw. "Major postpartum haemorrhage." Current opinion in Obstetrics and Gynecology13.6 (2001): 595-603.
Mousa, Hatem A., et al. "Treatment for primary postpartum haemorrhage." Cochrane Database Syst Rev 2.2 (2014): CD003249.