Postpartum hemorrhage protocol review: improving maternal emergency care

Abstract

Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide, despite advances in obstetric care. The objective of this study is to interpret the protocol for postpartum hemorrhage, with a focus on improving emergency maternal care, through a narrative review of recent scientific literature. An exhaustive search was conducted in PubMed, selecting studies published between January 2019 and July 2024. Studies addressing postpartum hemorrhage management protocols were included, excluding conference abstracts, letters to the editor, and preclinical studies. The results indicate significant variability in guidelines and recommended practices worldwide, with a general consensus on the use of oxytocin for the prevention of postpartum hemorrhage in vaginal deliveries. The implementation of structured protocols and continuous training are essential for improving maternal outcomes. Studies in Pakistan and France demonstrated the effectiveness of techniques adapted to local resources, and continuous audits highlighted the importance of adequate preparation and efficient management of obstetric emergencies. The lack of consensus in certain areas, such as fluid resuscitation, underscores the need for further research and a better synthesis of available evidence. In conclusion, the narrative review emphasizes the importance of evidence-based protocols adapted to local resources, as well as continuous training of health personnel, to reduce maternal morbidity and mortality and improve obstetric care globally.