What is the first-line treatment for postpartum hemorrhage?

The first-line treatment for postpartum hemorrhage is uterine massage, specifically bimanual uterine compression or massage. This intervention is crucial because the majority of postpartum hemorrhage cases are due to uterine atony, where the uterus fails to contract effectively after delivery. By performing uterine massage, healthcare providers aim to stimulate uterine contractions and reduce bleeding.

Uterine massage helps to promote the return of tone to the uterus, which is essential in minimizing blood loss. It is often the initial step taken immediately after delivery, especially when there are signs of excessive bleeding. In cases where uterine atony is present and massage alone does not suffice, medications such as oxytocin may be administered to further aid in uterine contraction.

While intravenous fluids, blood transfusions, and surgical interventions are also important components in managing severe postpartum hemorrhage, they are typically utilized after initial measures like uterine massage. Intravenous fluids are supportive and help address hypovolemia, blood transfusions may be necessary if significant blood loss has occurred, and surgical intervention is reserved for cases where other treatments fail to control the hemorrhage effectively. Thus, uterine massage is integral in addressing the immediate cause of postpartum hemorrhage and is the preferred first-line approach.