TABLE 2.

Care Bundles for Postpartum Hemorrhage, Sepsis, and Hypertensive Diseases of Pregnancy

Care Bundle	Items in the Care Bundle
PPH first response care bundle^a	TROM: Tranexamic Acid, Reposição volêmica (IV fluids), Oxytocic drugs, and Massage (uterine)^b Treat each of the 4 “Ts” accordingly (tone, trauma, tissue, and thrombin)
PPH second response care bundle^c	Calculate shock index Move patient to operation room Treat each of the 4 “Ts” accordingly Consider blood transfusion
HDPs care bundle	Collect laboratory tests for preeclampsia Magnesium sulfate loading dose Magnesium sulfate maintenance dose Control of blood pressure and respiratory rate Recalculate MEOWS Treat high blood pressure
Sepsis care bundle	Measure lactate level Obtain blood cultures prior to administration of antibiotics Administrate antibiotics Rapidly administer 500 mL IV solution Apply vasopressor after IV fluid to maintain mean arterial pressure ≥65 mmHg

↵^a For blood loss ≥500 mL (vaginal birth) or ≥1,000 mL (cesarean delivery), regardless of altered vital signs.
↵^b After this BTS, a group or researchers published an article proposing E-MOTIVE³⁶ instead of TROM. The elements of the bundle are the same, but arranged in a different order, which changes the acronym.
↵^c After applying the first response bundle and blood loss persists.
Abbreviations: BTS, Breakthrough Series; HDPs, hypertensive disorders of pregnancy; MEOWS, Modified Early Obstetric Warning Score; PPH, postpartum hemorrhage.