In our series, abnormal placentation causing severe haemorrhage was the commonest indication for EPH. Previous CS is a risk factor for abnormal placentation and particularly for morbid adherence of the placenta. The morbidity associated with EPH is considerable.

This large Australian single centre study shows outcomes equivalent to other Western series and approaches that of Japanese data. High survival figures can be achieved when gastrectomy is performed by an experienced institution through a multi-modality approach with adequate staging, aggressive and appropriate resection and selective use of perioperative therapy.

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small. Even after these second-line interventions, 26% of women required hysterectomy. Recent recommendations in the United Kingdom have encouraged obstetricians to consider all available therapies to stop hemorrhage. The authors of this study suggest that further research on the efficacy and cost effectiveness of the multiple second-line techniques available to treat PPH is necessary to develop evidence-based guidelines for their use.