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Revista Colombiana de Obstetricia y Ginecología

versão impressa ISSN 0034-7434

Resumo

LOPEZ-GARCIA, Luis Felipe; RUIZ-FEMANDEZ, Diana Paola; ZAMBRANO-CERON, Carlos Germán  e  RUBIO-ROMERO, Jorge Andrés. Incidence of postpartum hemorrhage based on the use of uterotonics. Maternal outcomes in an intermediate complexity hospital in Bogotá, Colombia, 2016. Rev Colomb Obstet Ginecol [online]. 2017, vol.68, n.3, pp.218-227. ISSN 0034-7434.  https://doi.org/10.18597/rcog.2916.

Objective:

To describe the incidence of obstetric postpartum haemorrhage (PPH), defined by the use of uterotonic drugs, as well as the interventions performed, and maternal outcomes in the first 24 hours.

Materials and methods:

A series of cases of pregnant women who presented PPH after vaginal delivery or cesarean section between February 1 and October 31, 2016, in a public intermediate complexity institution in Bogotá. Consecutive sampling was used. Sociodemographic, clinical and risk factors for PPH were measured. Variables measured were the cause of PPH, the degree of shock, estimated postpartum bleeding, frequency of activation of the "obstetric red code," interventions performed, admission to an intensive care unit, blood transfusions, and maternal mortality. A descriptive analysis was performed.

Results:

Out of 1633 births (1080 vaginal deliveries and 553 cesarean deliveries), 35 cases (2.1%) (26 and 9, respectively) were identified and the "obstetric red code" was activated in 11 cases (0.67%). There was no maternal mortality. The main cause of PPH was uterine hypotonia in 29/35 (82%), and 82.8% of the cases resolved with medical treatment. Uterine tamponade was required in 4/35 (11.4%) women to control bleeding, and surgical management was required in 2/35 (5.6%) women: haemostatic sutures in 1/35 (2.8%) and hysterectomy in 1/35 (2.8%).

Conclusions:

The use of more reproducible criteria for the identification of severe PPH and timely initiation of treatment could be safer and more effective in terms of maternal outcomes.

Palavras-chave : Postpartum haemorrhage; delivery; uterine balloon tamponade; treatment outcome.

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