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

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.