Secondary outcomes were total blood loss , total amount of blood transfused , occurrence of rebleeding , haemoglobin < 58 g litre ( -1 ) , RBC transfusion within 4 h , 24 h , and 7 days , and as a composite outcome of ` severe PPH ' , defined as a decrease in haemoglobin of > 40 g litre ( -1 ) , transfusion of at least 4 units of RBCs , haemostatic intervention ( angiographic embolization , surgical arterial ligation , or hysterectomy ) , or maternal death .