Management of Acute Gynecological Bleeding With a Multimodal Approach

This research addresses the integrated management of acute gynecological bleeding through multimodal approaches that combine pharmacological, minimally invasive surgical techniques and interventional radiology. It is contextualized in the growing need for effective and safe solutions to reduce maternal morbidity and mortality, given the clinical and organizational challenges of these emergency events. The problem focuses on the difficulties in implementing these integrated protocols and the clinical and economic impact of their practices. The general objective was to analyze the effectiveness, challenges and benefits of multimodal application in the control of these hemorrhages. To this end, the Giftedean neoperspectivist paradigm was adopted, integrating the theories of systems, complexity, decision, public health and health management. The hypothetical-deductive method was used to formulate and test the hypotheses, and a rigorous narrative bibliographic and documentary review was conducted, consulting databases such as PubMed, Scopus, Web of Science, Lilacs and SciELO, with specific descriptors related to the theme. A total of 138 studies selected from approximately 1,250 initially identified were analyzed. The main findings indicated the superiority of integrated approaches in reducing complications and costs, also identifying institutional barriers and proposing practical solutions. The conclusions highlight the effectiveness of multimodal protocols, the importance of training and multidisciplinary management, and gaps related to longitudinal studies and low-income contexts. Among the limitations, the lack of primary data and the narrative nature of the review stand out. The contributions include theoretical-methodological advancement and practical support for clinical policies and practices. The added value is reflected in the improvement of female care and in the strengthening of research in emergency health.