Hemorragia obstétrica en el posparto. Revisión sistemática

Abstract

Obstetric hemorrhage is defined as the loss of more than 500 ml of blood during vaginal delivery and more than 1000 ml during cesarean delivery. Objective: To determine the prevalence, causes, complications, and nursing care associated with postpartum obstetric hemorrhage. Methodology: This was an analytical, systematic review study conducted through the reading and analysis of scientific literature from the following databases: SciELO, Scopus, Dialnet, Taylor & Francis, PubMed, ProQuest, and Web of Science, focusing on studies published between 2018 and 2023. The quality of the literature was assessed using the CONSORT-2010 checklist. Results: A global prevalence of 80% was identified, with regional rates of 30.8% in Asia, 33.9% in Africa, and 30% in Colombia. In Ecuador, obstetric hemorrhage ranks as the second leading cause of maternal death and is more prevalent in low-income countries. The most common cause is uterine atony (61.5%), and the most frequent complication is hypovolemic shock. Treatment protocols, such as Ecuador's "Score MAMÁ" and the implementation of the Nursing Care Process based on the NANDA NOC-NIC Taxonomy, are essential. Conclusions: The prevalence of postpartum hemorrhage (PPH) varies, but it is more frequent in developing countries. Uterine atony is the leading cause of PPH, with complications including hypovolemic shock, acute renal failure, and disseminated intravascular coagulation. Timely nursing intervention is critical for prompt care and reducing maternal morbidity and mortality. Keywords: bleeding, hypovolemic shock, code red