Aplicación de ácido tranexámico para la reducción de hemorragias postparto y poscesárea.
Palabras clave:
Ácido tranexámico, hemorragia postparto, cesárea, parto natural.Resumen
Introducción: La hemorragia postparto sigue siendo una de las principales causas de mortalidad materna a nivel mundial, especialmente en entornos con recursos limitados, donde la detección oportuna y las intervenciones eficaces son deficientes. El ácido tranexámico, un agente antifibrinolítico, se ha utilizado para reducir la pérdida de sangre en diversos procedimientos quirúrgicos, incluidas las cirugías obstétricas. Objetivo: Evaluar la efectividad del ácido tranexámico en la reducción de la hemorragia postparto en partos vaginales y cesáreas, analizando su impacto en la pérdida de sangre, morbilidad y mortalidad materna. Materiales y metodos: Se realizó una búsqueda avanzada en PubMed, Google Académico y EMBASE, donde se obtuvieron 50 artículos de referencia para el análisis. Resultados: Se ha demostrado que el ácido tranexámico reduce significativamente la pérdida de sangre y la necesidad de transfusiones en cesáreas, como lo evidencian estudios como el ensayo WOMAN. En estos procedimientos, su administración se asoció con menores tasas de HPP severa y mortalidad materna. Sin embargo, su efectividad en partos vaginales es controversial. Algunos estudios sugieren una posible reducción en el uso de uterotónicos en mujeres no anémicas, pero sin beneficios significativos en la reducción global de la pérdida sanguínea, la mortalidad materna o las complicaciones graves. La seguridad del ácido tranexámico sigue en debate debido a la falta de datos concluyentes sobre eventos tromboembólicos. Conclusión: El ácido tranexámico es una herramienta valiosa en el manejo de la hemorragia obstétrica, especialmente en cesáreas, donde su eficacia está respaldada por evidencia sólida. Sin embargo, su uso rutinario en partos vaginales carece de pruebas contundentes, lo que resalta la necesidad de más estudios para evaluar su seguridad y efectividad en este contexto.
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