Secondary PPH

Q: Secondary postpartum hemorrhage (PPH) is defined as any significant uterine bleeding occurring after?

A) 24 hours postpartum
B) 48 hours postpartum
C) 72 hours postpartum
D) one week postpartum
E) it is not defined by time


Answer: A

Primary and secondary PPH is defined by the cutoff of a time period and is also limited by a time period. i.e., Secondary PPH is generally defined as any significant uterine bleeding between 24 hours and 12 weeks postpartum. This cutoff is set as management may become different for primary and secondary PPH.

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References:

1. Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol 2017; 130:e168. 

2. Dossou M, Debost-Legrand A, Déchelotte P, et al. Severe secondary postpartum hemorrhage: a historical cohort. Birth 2015; 42:149.