Complicaciones hemorrágicas en el puerperio, en parto vaginal versus cesárea. Revisión Sistemática

Abstract

Introduction: Postpartum hemorrhage represents 75 % of pathological puerperium cases and is considered the first cause of maternal mortality and morbidity worldwide, associated with almost a quarter of all maternal deaths. This study aims to analyze qualitatively the hemorrhagic complications in the puerperium in vaginal and cesarean deliveries. Methods: The information was obtained from academic search engines such as Medline, PubMed, and SciELO; 140 publications were chosen, and 19 met the selection criteria. Results: Several causes of postpartum hemorrhagic complications were identified; studies agree in different percentages that uterine atony is the leading cause of postpartum hemorrhage. Regarding risk factors, a record of severe postpartum hemorrhage, followed by multiple pregnancies, macrosomia, and anticoagulant medication, was found to be the most frequent. Conclusion: According to the available literature, hemorrhagic complications in the puerperium are caused mainly by uterine atony, followed by placental problems and coagulopathies. Qualitative analysis also suggests that cesarean deliveries are primarily associated with postpartum versus vaginal hemorrhage. Risk factors are not included in the care guidelines; these include ethnic factors, cervical trauma, hypertensive disease, and diabetes mellitus.