Primary postpartum haemorrhage (PPH) is a major cause of morbidity and the leading cause of direct maternal death worldwide,1 with uterine atony accounting for approximately 70% of cases.2 Oxytocin is the most commonly used uterotonic in the developed world, with recent Cochrane reviews showing that it is effective for treating PPH.3,4 However, failure of PPH prophylaxis with oxytocin, as shown by the need for a rescue uterotonic, has been demonstrated to be as high as 13% in women having an elective caesarean delivery (CD).
