The GTN (gestational trophoblastic neoplasia) prognostic scoring — NOT to be confused with WHO/FIGO GTN scoring — refers to the Newcastle scoring system for puerperal sepsis risk stratification. However, what is the most validated clinical scoring system currently recommended for screening for postpartum haemorrhage risk used routinely on the labour ward?

• A MEOWS (Modified Early Obstetric Warning Score)
• B Quantitative blood loss (QBL) using calibrated drapes combined with a validated PPH risk stratification tool at the beginning of labour ✓
• C HAEMOSTASIS mnemonic used as a sequential action algorithm
• D CRADLE-3 (Vital Signs Alert) for shock index-based haemorrhage detection

Explanation

Current ACOG (2019) and CMQCC recommendations advocate for standardised quantitative blood loss (QBL) measurement using calibrated drapes/suction canisters — replacing subjective visual estimation — combined with a validated PPH risk-assessment tool completed at admission (stratifying patients as low, medium, or high risk based on placenta praevia, prior PPH, multiple gestation, coagulopathy, etc.) and activating haemorrhage bundles when cumulative blood loss ≥500 mL after vaginal birth or ≥1000 mL after caesarean. CRADLE-3 uses shock index ≥1.7 to trigger escalation. MEOWS monitors vital signs throughout but is not specific to PPH.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.