O Papel da Oxitocina na Profilaxia da Hemorragia Pós-Parto em Locais com Recursos Limitados

Abstract

Introduction: Postpartum hemorrhage remains one of the leading causes of maternal death globally. Oxytocin is the uterotonic of choice for the prophylaxis of this complication, however its use in low-resource settings is associated with clinical, political, economic and cultural constraints. The goal of this monograph is to investigate the use of oxytocin for postpartum hemorrhage prophylaxis in low-resource settings. Material and Methods: A literature review on the topic was carried out, and twenty-four articles were selected. Results: The information was organized into seven sections: the evaluation of the oxytocin's efficacy compared to other uterotonics, the use of oxytocin in home births, the training of health professionals, the quality of the available oxytocin, the new formulations, the risks associated with the use of uterotonic and the adopted health policies. Discussion: Despite the progress achieved, it was found that widespread access to oxytocin for postpartum hemorrhage prophylaxis in low-resource settings is less than desirable. The main difficulties encountered were the shortage of skilled health professionals for oxytocin administration, deficiencies on the quality of the drug and the inadequacy of available clinical guidelines. Conclusion: To reduce maternal mortality caused by postpartum hemorrhage in low-resource settings, it is of utmost importance to improve the knowledge of health professionals, to implement good practices on the use of uterotonics, to optimize resource management and to overcome cultural barriers that prevent the demand for health services.