Curationis 32 (1): 59-66MOU, am bulance, response tim e, Response times of ambulances to calls from Midwife Obstetric Units, although var-^MNS jc(j, are perceived as slow. Delays in transporting women experiencing complications during or after their pregnancies to higher levels o f care may have negative conse quences such as fetal, neonatal or maternal morbidity or death.An exploratory descriptive study was undertaken to investigate the response times of ambulances of the Western Cape Emergency Medical Services to calls from mid wife obstetric units (MOUs) in the Peninsula Maternal and Neonatal Services (PMNS) in Cape Town. Response times were calculated from data collected in specific MOUs using a specifically developed instrument. Recorded data included time o f call placed requesting transfer, diagnosis or reason for transfer, priority of call and the time of arrival o f ambulance to the requesting facility. Mean, median and range o f response times, in minutes, to various MOUs and priorities of calls were calculated. These were then compared using the Kruskal-Wallis test. A comparison was then made between the recorded and analysed response times to national norms and recommendations for ambulance response times and maternal transfer response times respectively.A wide range o f response times was noted for the whole sample. Median response times across all priorities o f calls and to all MOUs in sample fell short o f national norms and recommendations. No statistical differences were noted between various priorities o f calls and MOUs.

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The development of clear approaches to the assessment, resuscitation, treatment and monitoring of the four case scenarios are presented as algorithms, based on available evidence. They need to be field tested, and adapted for Artificial intelligence and different settings. Further research is needed around multimodal sequential care package of care for PPH, conservative surgical measures, resuscitation in LMICs, and the psychological impact of PPH on women.

AimsTo develop algorithms for identifying, managing and monitoring postpartum haemorrhage (PPH) and other third stage of labour abnormalities after vaginal delivery.PopulationWomen with low‐risk singleton term pregnancies who have had a vaginal delivery.SettingHospital settings with a particular focus on healthcare facilities in low‐ and middle‐income countries (LMICs).Search strategySearches for international and national guidance documents, research databases (Cochrane, Medline and CINAHL) and published systematic reviews. Searches were limited to work published in English between 1 January 2008 and 31 December 2018.Case scenariosFour interlinked case scenarios were identified for algorithm development: (1) an approach to PPH after vaginal delivery, (2) uterine atony, (3) genital tract trauma and (4) retained placenta/placental products.ConclusionsThe development of clear approaches to the assessment, resuscitation, treatment and monitoring of the four case scenarios are presented as algorithms, based on available evidence. They need to be field tested and evaluated for effectiveness, and may be adapted for electronic decision support tools using artificial intelligence in different settings. Further research is needed around multimodal sequential packages of care for PPH, conservative surgical measures, resuscitation in LMICs, and how a respectful maternity care focus can be incorporated into the algorithms.Tweetable abstractAlgorithm development for standardised approaches to managing PPH in low‐resource settings.