MATERNAL SAFETY: THE IMPACT OF NURSING PRACTICES ON THE MANAGEMENT OF POSTPARTUM HEMORRHAGE

Abstract

This study aims to analyze postpartum hemorrhage (PPH) as an obstetric emergency and to highlight the role of nursing in its management. PPH represents one of the leading causes of maternal death globally, with 14 million cases annually and 140,000 deaths, and is particularly prevalent in developing countries. A narrative literature review was carried out in databases such as Google Scholar, PAHO, Ministry of Health, and COFEN, using descriptors related to PPH and nursing care, with publications between 2009 and 2022. The results showed the evolution of the guidelines for PPH, currently considering blood loss ≥1000 mL or signs of hypovolemia. Significant risk factors were identified, such as previous history of PPH and multiple pregnancies, and the importance of the "4Ts" Rule (Tone, Trauma, Tissue and Thrombin) for etiological identification. The study revealed critical failures in maternal management, including delayed diagnosis and insufficient postpartum monitoring. It was found that nursing care is crucial in the management of PPH, through the systematic assessment of vital signs, monitoring of blood loss, and implementation of interventions such as oxytocin administration, uterine massage, and promotion of immediate breastfeeding. The Systematization of Nursing Care emerges as an essential methodology to ensure individualized and evidence-based care, contributing significantly to the reduction of maternal morbidity and mortality related to PPH.