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Comparison of Maternal Outcomes After Postpartum Hemorrhage (PPH) With and Without the E-MOTIVE Bundle

Sobia Nawaz1, Sania Khan2, Khadija Waheed3, Rubaba Abid Naqvi1, Umaira Maqsood4, Mahwish Jamil5
1Obstetrics and Gynecology, RTH, Rawalpindi, Pakistan
2Women Medical Officer, Department of Obstetrics and Gynecology, DHQ, Nankana Sahib, Pakistan
3Obstetrics and Gynecology, Sargodha Medical College, Sargodha, Pakistan
4Consultant Gynecologist, RHC Qila Ahmedabad, Pakistan
5Senior Registrar, Gynecology Unit 4, Sir Ganga Ram Hospital, Lahore, Pakistan
DOI: https://doi.org/10.70517/revcc2624163
Published: 15/10/2026
: Sobia Nawaz, Sania Khan, Khadija Waheed, Rubaba Abid Naqvi, Umaira Maqsood, Mahwish Jamil. Comparison of Maternal Outcomes After Postpartum Hemorrhage (PPH) With and Without the E-MOTIVE Bundle. Revista Cultura Científica, 2026 Issue 24. pg. 1948-1957.

Abstract

Postpartum hemorrhage (PPH) is among the most important causes of maternal morbidity and mortality worldwide, particularly in resource-limited settings. Early recognition and prompt management are essential to minimizing adverse maternal outcomes and preventing the progression of obstetric bleeding. The E-MOTIVE bundle is an evidence-based approach designed to improve the early detection and systematic treatment of PPH. This study aimed to compare maternal outcomes following PPH in women managed with and without the E-MOTIVE bundle. A quasi-experimental study was conducted in the Department of Obstetrics and Gynecology, Rawalpindi Teaching Hospital, Rawalpindi, from April to July 2026. A total of 142 women diagnosed with primary PPH were recruited using non-probability consecutive sampling and were allocated by lottery into two equal groups. Group A received management according to the E-MOTIVE bundle, whereas Group B received standard care. Baseline demographic and obstetric information was documented. The measured outcomes included mean blood loss, blood transfusion requirements, and maternal mortality. Data were analyzed using SPSS version 27. Independent-samples t-tests and chi-square or Fisher’s exact tests were used as appropriate, with p < 0.05 considered statistically significant. Mean reported blood loss was significantly lower in Group A than in Group B (250.80±188.88 mL versus 373.80±286.90 mL; p = 0.003). Blood transfusions were required in 0% of women in the E-MOTIVE group and 2.8% of women receiving standard care (p = 0.496). One maternal death was recorded in the standard-care group and none in the E-MOTIVE group; this difference was not statistically significant. The findings suggest that E-MOTIVE-based management was associated with lower reported blood loss than routine care in this single-center study, while differences in transfusion requirements and mortality were inconclusive. Interpretation of the blood-loss outcome requires confirmation of its measurement interval and relationship to the study’s diagnostic definition of PPH.

Keywords: Postpartum hemorrhage; E-MOTIVE-based management; diagnostic

Abstract

Postpartum hemorrhage (PPH) is among the most important causes of maternal morbidity and mortality worldwide, particularly in resource-limited settings. Early recognition and prompt management are essential to minimizing adverse maternal outcomes and preventing the progression of obstetric bleeding. The E-MOTIVE bundle is an evidence-based approach designed to improve the early detection and systematic treatment of PPH. This study aimed to compare maternal outcomes following PPH in women managed with and without the E-MOTIVE bundle. A quasi-experimental study was conducted in the Department of Obstetrics and Gynecology, Rawalpindi Teaching Hospital, Rawalpindi, from April to July 2026. A total of 142 women diagnosed with primary PPH were recruited using non-probability consecutive sampling and were allocated by lottery into two equal groups. Group A received management according to the E-MOTIVE bundle, whereas Group B received standard care. Baseline demographic and obstetric information was documented. The measured outcomes included mean blood loss, blood transfusion requirements, and maternal mortality. Data were analyzed using SPSS version 27. Independent-samples t-tests and chi-square or Fisher’s exact tests were used as appropriate, with p < 0.05 considered statistically significant. Mean reported blood loss was significantly lower in Group A than in Group B (250.80±188.88 mL versus 373.80±286.90 mL; p = 0.003). Blood transfusions were required in 0% of women in the E-MOTIVE group and 2.8% of women receiving standard care (p = 0.496). One maternal death was recorded in the standard-care group and none in the E-MOTIVE group; this difference was not statistically significant. The findings suggest that E-MOTIVE-based management was associated with lower reported blood loss than routine care in this single-center study, while differences in transfusion requirements and mortality were inconclusive. Interpretation of the blood-loss outcome requires confirmation of its measurement interval and relationship to the study’s diagnostic definition of PPH.

Keywords: Postpartum hemorrhage; E-MOTIVE-based management; diagnostic

References

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Sobia Nawaz
Obstetrics and Gynecology, RTH, Rawalpindi, Pakistan
mughalbia835@gmail.com
Sania Khan
Women Medical Officer, Department of Obstetrics and Gynecology, DHQ, Nankana Sahib, Pakistan
Khadija Waheed
Obstetrics and Gynecology, Sargodha Medical College, Sargodha, Pakistan
Rubaba Abid Naqvi
Obstetrics and Gynecology, RTH, Rawalpindi, Pakistan
Umaira Maqsood
Consultant Gynecologist, RHC Qila Ahmedabad, Pakistan
Mahwish Jamil
Senior Registrar, Gynecology Unit 4, Sir Ganga Ram Hospital, Lahore, Pakistan

How to cite:

Sobia Nawaz, Sania Khan, Khadija Waheed, Rubaba Abid Naqvi, Umaira Maqsood, Mahwish Jamil. Comparison of Maternal Outcomes After Postpartum Hemorrhage (PPH) With and Without the E-MOTIVE Bundle. Revista Cultura Científica, 2026 Issue 24. pg. 1948-1957.

Publication History

  • Received: 22/07/2026
  • Accepted: 02/10/2026
  • Published: 15/10/2026
Copyright © 2026, Sobia Nawaz, Sania Khan, Khadija Waheed, Rubaba Abid Naqvi, Umaira Maqsood, Mahwish Jamil. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

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