Several preventive strategies can help curtail the inci-dence of delivery-associated hemorrhage, and many are quite effective. Active management of the third stage of labor, which involves immediate manual removal of the placenta and the administration of a uterotonic agent, has been shown to reduce the incidence of hemorrhage. In addition to preventing many cases of uterine atony, this approach will also reduce the incidence uterine inversion. The incidence of retained placenta is not increased with these techniques.
Finally, all obstetric units and practitioners must have the facilities, personnel, and equipment in place to man-age PPH properly. Clinical drills to enhance the manage-ment of maternal hemorrhage are also recommended.