Actualización de hemorragia posparto. Revisión sistemática

Abstract

Background: Postpartum hemorrhage (PPH) is an obstetric complication with high morbidity and mortality, a problem that is accentuated in developing countries, due to its repercussions, timely identification and management is a priority. General objective: to determine the prevalence, causes, risk factors and effectiveness of the medical and / or surgical treatment of PPH. Methodology: systematic review. Controlled, randomized clinical trials, analytical, descriptive studies, published in the last 5 years, without language discrimination, were included. The search was carried out in electronic databases such as Cochrane Library Plus, Embase, Pubmed and Lilacs. The information was synthesized in personalized tables. Results: the prevalence of PPH fluctuates between 2.1% and 79.6%. Uterine atony was the most common cause of PPH, followed by trauma. Age ≥ 35 years, nulliparity, history of PPH, hypertensive disorders of pregnancy, longer duration of the third stage of labor, instrumental deliveries, and perineal tears were considered as risk factors. Hayman suture showed effectiveness between 87 and 95.1% and hydrostatic balloon tamponade between 91 and 96% in the PPH control. Conclusions: the prevalence varies according to access to health, uterine atony was the most frequent cause, nulliparity was the factor most commonly associated with PPH. The Hayman suture and hydrostatic tamponade showed high effectiveness in the management of PPH. Limitations: restriction on access to information by economic category, in addition, limited studies with representative samples that evaluated the effectiveness in the management of PPH.