Obstetrics

Postpartum Hemorrhage (PPH) Risk Assessment (ACOG / CMQCC)

Stratifies obstetric postpartum hemorrhage risk into Low, Medium, or High risk to guide blood banking and uterotonics.

Enlarge

Parameters

Placenta Previa, Low-Lying Placenta, or Suspected Accreta Spectrum (PAS) (HIGH RISK)

Active antepartum vaginal bleeding on admission (HIGH RISK)

Known coagulopathy or severe thrombocytopenia (Platelets < 50,000/µL) (HIGH RISK)

Severe anemia (Hematocrit < 30%) WITH other risk factors (HIGH RISK)

Prior Cesarean delivery or uterine myomectomy (Medium Risk)

Multiple gestation (Twins, triplets) (Medium Risk)

High parity (> 4 prior vaginal births) (Medium Risk)

Prior history of postpartum hemorrhage (Medium Risk)

Large uterine fibroids / leiomyomas (Medium Risk)

Suspected fetal macrosomia (EFW > 4,000 g) (Medium Risk)

Morbid obesity (BMI ≥ 40 kg/m²) (Medium Risk)

Intravenous Magnesium Sulfate infusion (Medium Risk)

Intraamniotic infection / Chorioamnionitis (Medium Risk)

Prolonged oxytocin augmentation (> 24h) or prolonged 2nd stage (Medium Risk)

Postpartum Hemorrhage (PPH) Risk Assessment (ACOG / CMQCC) Result

FormulaStratified according to CMQCC/ACOG obstetric hemorrhage screening checklist on admission to Labor & Delivery.

Clinical Pearls

Proven to dramatically decrease maternal blood transfusions, emergency hysterectomies, and severe maternal morbidity during childbirth.

Limitations

Dynamic assessment: patients who enter at low risk can develop medium/high risk during labor (e.g. chorioamnionitis, prolonged oxytocin augmentation).