Althabe F. auteur aut IRD Therrien M. N. S. auteur aut IRD Pingray V. auteur aut IRD Hermida J. auteur aut IRD Gulmezoglu A. M. auteur aut IRD Armbruster D. auteur aut IRD Singh N. auteur aut IRD Guha M. auteur aut IRD Garg L. F. auteur aut IRD Souza J. P. auteur aut IRD Smith J. M. auteur aut IRD Winikoff B. auteur aut IRD Thapa K. auteur aut IRD Hebert E. auteur aut IRD Liljestrand J. auteur aut IRD Downe S. auteur aut IRD Elorrio E. G. auteur aut IRD Arulkumaran S. auteur aut IRD Byaruhanga E. K. auteur aut IRD Lissauer D. M. auteur aut IRD Ogutu M. auteur aut IRD Dumont Alexandre auteur aut IRD Escobar M. F. auteur aut IRD Fuchtner C. auteur aut IRD Lumbiganon P. auteur aut IRD Burke T. F. auteur aut IRD Miller S. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Objective To systematically develop evidence-based bundles for care of postpartum hemorrhage (PPH). Methods An international technical consultation was conducted in 2017 to develop draft bundles of clinical interventions for PPH taken from the WHO's 2012 and 2017 PPH recommendations and based on the validated "GRADE Evidence-to-Decision" framework. Twenty-three global maternal-health experts participated in the development process, which was informed by a systematic literature search on bundle definitions, designs, and implementation experiences. Over a 6-month period, the expert panel met online and via teleconferences, culminating in a 2-day in-person meeting. Results The consultation led to the definition of two care bundles for facility implementation. The "first response to PPH bundle" comprises uterotonics, isotonic crystalloids, tranexamic acid, and uterine massage. The "response to refractory PPH bundle" comprises compressive measures (aortic or bimanual uterine compression), the non-pneumatic antishock garment, and intrauterine balloon tamponade (IBT). Advocacy, training, teamwork, communication, and use of best clinical practices were defined as PPH bundle supporting elements. Conclusion For the first response bundle, further research should assess its feasibility, acceptability, and effectiveness; and identify optimal implementation strategies. For the response to refractory bundle, further research should address pending controversies, including the operational definition of refractory PPH and effectiveness of IBT devices. specialized Aortic compression Bimanual compression Intrauterine balloon tamponade Non-pneumatic antishock garment Obstetric hemorrhage Patient care bundles Postpartum hemorrhage Tranexamic acid Uterotonics MONDE 050 148 3 290-299 2020 0020-7292 https://www.documentation.ird.fr/hor/fdi:010077739 10.1002/ijgo.13028 0020-7292 [F B010077739] https://www.documentation.ird.fr/hor/fdi:010077739 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-01/010077739.pdf IRD - Base Horizon / Pleins textes 2020-02-05 2025-02-24 fdi:010077739 fre