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Primary Postpartum Hemorrhage

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"last update: 17 December  2025"                                                                          Download Guideline

- Appendix

The EMOTIVE FIRST BUNDLE:Top of Form

Early detection, Massage the uterus, Oxytocic drugs, Tranexamic acid, IV fluids,

èExamination & Escalation



Appendix II

Components of the Modified Early Obstetric Warning Score (MEOWS) (Joint Trust Guideline for the use of the Modified Early Obstetric Warning Score (MEOWS) in Detecting the Seriously Ill and Deteriorating Woman; 25/02/2022, Internet download from https://www.nnuh.nhs.uk/publication/download/modified-early-obstetric-warning-score-meows-mid33-ao13-v7/),

MEOW Sore

3

2

1

0

1

2

3

1.Temp oC

< 35

35-35.9

36-37.4

37.5 -37.9

38-38.9

≥ 39

2.Sys BP

< 70

70-79

80-89

90-139

140-149

150-159

≥ 160

3.Dias BP

≤ 49

50-89

90-99

100-109

≥ 110

4.Pulse

<40

40-49

50-99

100-109

110-129

≥ 130

5.R R

≤ 10

11-19

20-24

25-29

≥ 30

6.AVPU

Alert

Respond to Voice

Respond to Pain

Unresponsive

7.UOP

ml/hr

< 10

< 30

> 30

8. ± O2 Sat*

≤ 90%

91-94%

95%

*Any woman who triggers a MEOWS of ≥ 4, or 3 in any one parameter should have their oxygen saturations recorded with each full set of observations.

Interpretation (GPS):

Green Pathway - expedited management, Score 1-3

Amber Pathway - urgent management, Score 4 or 5 or score 3 in a single item

Red Pathway - emergency management, Score ≥ 6

There is no substitute for wise physician judgment


Appendix III:

A flow chart of the different steps for the management of PPH