vaginal birth after cesarean delivery: a review of the literature. Acog practice bulletin #54: vaginal birth after previous cesarean. Coagulation defects should be suspected in patients who have not responded to the usual measures to treat post-partum hemorrhage, and in those who are not forming blood clots or are oozing from puncture sites. Commonest mode of delivery which was found in our setup was Spontaneous vaginal delivery followed by C-section, while nearly half of the cases of spontaneous vaginal delivery undergo episiotomy. 13 Strategies for minimizing the effects of postpartum hemorrhage include identifying and correcting anemia before delivery, being aware of the mother's beliefs about blood transfusions, and eliminating routine episiotomy. No Methods of management Primary post partum hemorrhage n Secondary post partum hemorrhage n p-value 1 Evacuation of remaining products of conception 0 8(100).01 2 Repair of cervical and vaginal tear 6(75) 2(25.671 3 Internal iliac ligation 2(100).326 4 Hysterectomy 8(100). Out of 8 patients of secondary post partum hemorrhage, 2(p.67) also had cervical or vaginal tear and for their management two methods of management were used, evacuation of remaining products of conception and repair of cervical or vaginal tear (Table ). 57 BD-NET sales, BY geography, 2015 FIG. Coagulopathies require clotting factor replacement for the identified deficiency. Oleen MA, Mariano.