Postnatal Bleeding < 6 completed weeks from Delivery (446) | Right Decisions

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Common obstetric problems, maternity assessment
Postnatal Bleeding < 6 completed weeks from Delivery (446)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Please report any inaccuracies or issues with this guideline using our online form

(if > 6weeks – refer to Gynaecology)
Review history – Labour / Delivery and 3rd stage.

There are no randomised controlled trials to inform the management of secondary PPH (Cochrane 2002).

The diagnosis and management of secondary PPH primarily relies on clinical assessment. Ultrasound has a high false positive rate as it is difficult to differentiate between retained products and blood clot.

Assess the woman
1. Estimate total blood loss
2. Vital signs (temperature, pulse, blood pressure)
3. Follow either Flow chart A (stable patient) or Flow chart B (patient clinically unwell).

Flow chart A : Patient stable

Flow chart B : Patient clinically unwell

Last reviewed: 16/08/2018

Next review date: 31/12/2022

Author(s): Julie Murphy.

Version: 2

Approved By: Obstetrics Clinical Governance Group

Document Id: 446