Manejo de la tercera etapa del parto para prevenir la hemorragia post parto. Revisión bibliográfica.

Abstract

Introduction: Postpartum hemorrhage (PPH) is the leading cause of preventable maternal morbidity and mortality, affecting 14 million women annually, primarily in low- and middle-income countries. Globally, there are 529,000 pregnancy-related deaths, 30% of which are due to PPH. In Ecuador, a significant number of women die annually from PPH. Active management of the third stage of labor is a strong proposal for reducing these figures. Objective: To describe the strategies for the preventive management of postpartum hemorrhage during the third stage of labor through a comprehensive literature review, identifying clinical practices that promote improvements in maternal and neonatal health. Methods: A search was conducted in PubMed, Cochrane Library, LILACs, and Google Scholar, using publications from 2019-2024. Keywords such as "Postpartum Hemorrhage," "Clinical Practices," "Prevention," and "Third Stage of Labor" were used. Articles focused on the effectiveness and improvements of preventive management were selected. Results: Active management reduces the incidence of PPH by up to 50%. The need for transfusions and other interventions is also reduced. Oxytocin is the preferred uterotonic due to its effectiveness and safety. Current trends show modifications in the use of controlled cord traction, early cord clamping, and uterine massage. Conclusion: Postpartum hemorrhage is a major cause of maternal morbidity and mortality. Active management of the third stage of labor has proven to be effective, but its implementation faces challenges such as resource shortages and variability in protocol application.