Comprehensive approach to postpartum haemorrhage from a nursing perspective

Abstract

This study addressed postpartum haemorrhage (PPH) as one of the leading causes of maternal mortality in Ecuadorian hospitals. It analysed the classification of PPH into primary and secondary, its causes, clinical manifestations, pathophysiology, and treatment. Uterine atony was highlighted as the most frequent factor, followed by trauma, tissue retention, and coagulopathies. In addition, multiple risk factors that compromised maternal health were identified, such as multiple pregnancies, foetal macrosomia, previous caesarean sections, and prolonged labour. The study showed that many of the deaths could have been prevented through timely and appropriate intervention by health personnel, especially nursing professionals. In this regard, the Nursing Care Process (NCP) was analysed as a key tool for ensuring effective, evidence-based care. Dorothea Orem's self-care theory, which proposed the active participation of women in their recovery process, was also integrated. The importance of intervention strategies focused on constant monitoring, administration of uterotonics, comprehensive clinical assessment, and interprofessional coordination was highlighted. Finally, the regulatory support of the Free Maternity Law was highlighted as a legal framework that guaranteed access to adequate care. This research contributed significantly to the training of nursing professionals and the strengthening of a preventive approach to PPH.