Browsing by Author "Salazar Blanco, Alexandra"
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Item Hemorragia posparto: la mejor evidencia disponible, prevención y manejo – revisión de la literatura(Universidad Santiago de Cali, 2024) Salazar Blanco, Alexandra; Narváez Cardona, Laura Isabel; García Clavijo, Johanna Andrea (Directora)Introduction: Postpartum hemorrhage is considered the leading cause of maternal mortality worldwide, which, despite advances in knowledge of management and prevention, has not been inevitable. Efforts to improve conditions in health care institutions are immense in terms of management, but prevention is a significant weakness. It is currently estimated that around 287,000 women died during and after pregnancy and childbirth in 2020. Nearly 95% of all maternal deaths occurred in low- and lower-middle-income countries in 2020, and most could have been prevented. Objective: To review the best available evidence published in the last 8 years (2016-2024) on management and prevention of postpartum hemorrhage worldwide. Methodology: This is a retrospective study of analysis and review of the literature, taking the most recent guidelines published by the scientific societies of obstetrics and gynecology in each continent (SCOG, FIGO, SOGON, FOGSI, NESOG, FLASOG, ACOG, RANZCOG, RCOG). For each society we searched websites where updated published guidelines were identified, as well as searches in PudMed, Science Direct, National Library of Medicine and National Guideline Clearinghouse databases. Results: Starting with the definition of PPH, the consensus in all guidelines proposes a grade 1 A evidence recommendation for hemodynamic instability rather than volume of blood loss. For use of uterotonics such as oxytocin in prevention and management of postpartum hemorrhage the evidence recommendation is grade 1 A, the use of tranexamic acid is also reiterated with grade 1 A recommendation in all cases of postpartum hemorrhage. Conclusions: The guidelines of all societies aim to improve the definition of postpartum hemorrhage in terms of hemodynamic instability and provide their best evidence recommendations for prevention with the use of uterotonics, continuing in first place oxytocin. They also emphasize the recognition of risk factors to generate prevention interventions, since management is fully recognized.