Revised Queensland Clinical Guideline: Primary postpartum haemorrhage (PPH)

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Queensland Clinical Guidelines has released the amended Primary postpartum haemorrhage (PPH) statewide clinical guideline (Guideline Number: MN18.1-V8-R23). Following is a summary of the changes.

Initiated following evidence updates to carbetocin use for PPH:

  • 2.3 Intrapartum risk management
    • Emergency caesarean section: Use of carbetocin added
    • Elective caesarean section: Evidence for carbetocin use deleted (use of carbetocin retained) 
  • 2.3.1 Third stage management 
    • Added new evidence for oxytocin IV versus IM 
  • 2.3.2 Syntometrine 
    • Moved from third stage management 
    • Added carbetocin preferred to syntometrine 
  • 2.3.3 Carbetocin 
    • Added. New content 
  • 2.3.4 Secondary prevention with misoprostol 
    • Moved from postnatal risk management (no change to content) 
    • Minor formatting updates 

These guideline replaces the previous version and as such all printed copies should be replaced. All published guidelines have undergone rigorous development processes involving broad statewide consultation, and endorsement by the Statewide Maternity and Neonatal Clinical Network on behalf of Queensland Health.

Additional Information

The clinical guideline is accompanied by a guideline supplement which presents the methodology, levels of evidence, and suggested implementation methods. The supplement is integral to and should be read in conjunction with the guideline. Additional information aligned to this guideline is also available, including posters and flowcharts, knowledge assessments, educational presentations and patient information.

Guideline Supplement

Flowcharts and posters


Patient information

For more information about Queensland clinical guidelines and clinical care standards see the CKN Clinical Guidelines page, or visit

last updated: 
Tuesday, 2 April, 2019