Eficácia e segurança de diferentes esquemas de manejo da Hemorragia Pós-Parto em contextos de recursos limitados: uma revisão sistemática

Abstract

Introduction: Postpartum Hemorrhage (PPH) remains the leading cause of maternal mortality in limited resource contexts, where access to specialized interventions is restricted. Objective: To evaluate the efficacy and safety of different PPH management schemes available for implementation in low-resource settings. Methods: Systematic review conducted following PRISMA guidelines, with search in PubMed, Cochrane Library, LILACS and SciELO until May 2024, using terms related to PPH, management and limited resources. Randomized clinical trials and comparative observational studies were included. Results: Of the 27 included studies, schemes with first-line uterotonics (oxytocin) associated with uterine tamponade measures demonstrated 85-92% efficacy in controlling primary PPH. Misoprostol proved to be an effective alternative (RR 0.83; 95%CI 0.76-0.91) when oxytocin is not available. Non-pharmacological interventions such as intrauterine balloon tamponade were successful in 78-88% of cases. Conclusion: Combined strategies adapted to local reality prove more effective for PPH management in limited resource contexts.