Efectividad de las intervenciones farmacológicas escalonadas versus técnicas no farmacológicas (suturas compresivas, ligadura de arterias uterinas y taponamiento intrauterino) en el manejo de la hemorragia posparto: una revisión sistemática
Resumen
La hemorragia posparto (HPP) es una de las principales causas de mortalidad materna mundial, responsable de una proporción significativa de muertes y requiere manejo oportuno y escalonado. El objetivo fue evaluar la efectividad de intervenciones farmacológicas escalonadas frente a técnicas no farmacológicas en el manejo de la HPP. Se realizó una búsqueda sistemática en bases de datos como Cochrane PubMed EMBASE Scopus y Google Scholar incluyendo estudios entre 2020 y 2025 en mujeres de 15-49 años. Se incluyeron ensayos clínicos aleatorizados estudios observacionales revisiones sistemáticas con síntesis cualitativa debido a heterogeneidad. Las intervenciones farmacológicas especialmente oxitocina y ácido tranexámico redujeron pérdida sanguínea transfusiones y progresión a HPP grave. Las técnicas no farmacológicas como suturas compresivas ligaduras arteriales y balón uterino mostraron alta eficacia en casos refractarios. Las estrategias combinadas mostraron mejores resultados en reducción de histerectomía y recurrencia. Se identificó heterogeneidad y limitada evidencia comparativa directa. En conclusión, el manejo óptimo de la hemorragia posparto debe basarse en un enfoque escalonado que integre intervenciones farmacológicas y técnicas no farmacológicas en casos refractarios, lo que reduce la morbilidad la progresión a HPP grave la necesidad de histerectomía y la mortalidad materna, respaldando la implementación de protocolos estandarizados en contextos recursos limitados.
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Derechos de autor 2026 Nicole Antonella Garcia Bastidas, Nataly Susana Urgilez Gutiérrez, María Fernanda Mendoza Yamunaque
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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