Basics of PPH
The Four Ts of PPH
Clinical Manifestation
Nursing Management
100

PPH is defined as a cumulative blood loss greater than this amount, or any blood loss accompanied by hypovolemic signs within 24 hours.

What is 1000 ml

100

This T refers to failure of the uterine muscle to contract.

What is Tone

100

A boggy uterus and excessive bright red bleeding indicate this condition.

What is Uterine Atony

100

This is the first-line physical intervention to improve uterine tone.

Uterine Massage

200

This type of PPH occurs within the first 24 hours after birth.

What is Primary PPH

200

Retained placenta falls under this T.

What is Tissue

200

In trauma‑related PPH, the uterus usually presents in this state.

What is contracted

200

This medication is administered IV or IM to support uterine contraction.

What is Oxytocin

300

This type of PPH occurs from 24 hours postpartum to 6 weeks.

What is Secondary/Late PPH

300

These four factors as a group help guide assessment and early intervention

What is Tone, Trauma, Tissue, Thrombin

300

Accurate measurement of postpartum bleeding requires this process.

What is quantification of blood loss

400

These two vital‑sign changes are late—not early—signs of PPH.

What is Tachycardia and Hypotension