Clinical and Therapeutic Characterization of Postpartum Hemorrhage in Patients at Sermesa Hospital, Masaya, Nicaragua
Keywords:
maternal mortality; morbidity and mortality indicators; postpartum hemorrhage; uterine inertia; uterotonic agentsAbstract
Introduction: postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide.
Objective: to characterize patients with postpartum hemorrhage from an epidemiological, clinical, and therapeutic perspective at Sermesa Hospital, Masaya, from February 2024 to June 2025.
Methods: a mixed-method, descriptive cross-sectional study was conducted in 72 patients with postpartum hemorrhage. Epidemiological and obstetric variables (parity and mode of delivery), clinical variables (type, timing, and cause of hemorrhage), and the type of treatment administered were analyzed. Factors influencing treatment selection and the level of adherence to clinical protocols were assessed through specialists’ opinions obtained via semi-structured interviews. Data were collected from medical records and summarized as percentages.
Results: the 25–34 years age group predominated (51.40 %), with a higher proportion of patients from rural areas (56.00 %). Most cases corresponded to immediate postpartum hemorrhage (94.40 %), in which uterine atony was the most frequent cause. Initial management was based on the use of uterotonic agents and uterine massage, while surgical intervention was less frequently required. Adequate adherence to clinical protocols was observed in most cases. The choice of treatment was influenced by the patients’ clinical condition, the cause of hemorrhage, the clinical experience of the medical staff, the availability of resources, and the response to initial management.
Conclusions: conservative medical management predominated, was effective in most cases, and showed adequate adherence to institutional protocols, providing valuable local evidence to strengthen clinical practice and reduce maternal morbidity and mortality.
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