Introduccion : la hemorragia obstetrica es la principal causa de muerte materna en el mundo. En Colombia la hemorragia posparto es la segunda causa de fallecimientos asociados al embarazo. Puede ser primaria (HPPP) o secundaria. Las primarias se presentan en las primeras 24 horas despues del nacimiento y son las mas frecuentes. Objetivo : identificar los factores etiologicos y las propuestas terapeuticas para el manejo de la HPPP. Metodologia: se realizo busqueda electronica en las bases de datos PubMed, ScienceDirect, EBSCOhost, Ovid y Scielo, textos de obstetricia y guias de manejo, publicados desde enero del 2005 a diciembre de 2013. Tambien en los documentos y guias del Ministerio de Salud y Proteccion Social de Colombia. Resultados: se seleccionaron 52 estudios para revision y se escogieron 30 que cumplian con los criterios de inclusion. Conclusiones: los factores etiologicos se recuerdan por la nemotecnia de las 4Ts (tono, trauma, tejido y trombina). La atonia (alteracion del tono) se presenta en el 80% de los casos y su manejo consiste en masaje uterino, oxitocina, metilergonovina o misoprostol. Entre las medidas no farmacologicas se citan el balon Bakri, embolizacion, ligadura de arterias hipogastricas o uterinas, cirugia de B-Lynch e histerectomia abdominal subtotal o total. Las otras causales de HPPP son las lesiones del canal del parto, la retencion de restos ovulares y las alteraciones de la coagulacion, que tienen manejos especificos. La identificacion de los factores etiologicos para HPPP, permite las pautas tempranas para el manejo, lo que evita morbilidad y reduce la mortalidad. Es fundamental la implementacion de protocolos institucionales. Rev.cienc.biomed.2014;5(2):307-316. PALABRAS CLAVE Hemorragia postparto; Oxitocina; Metilergonovina; Misoprostol SUMMARY Introduction: the obstetric hemorrhage is the main cause of maternal death in the world. In Colombia the postpartum hemorrhage is the second cause of deaths associated with the pregnancy. It could be primary (PPH) or secondary. The primary ones appear in the first 24 hours after the birth and are the most frequent. Objective: To identify the etiological factors and the therapeutic proposals for the management of the PPH. Methods: Electronic search was carried out in the databases PubMed, ScienceDirect, EBSCOhost, Ovid and scielo, textbook of obstetric and guidelines for its management published since January, 2005 to December, 2013. Also, in the documents and guidelines of the Ministerio de Salud y Proteccion Social de Colombia. Results: 52 studies were selected for review and there were chosen 30 that were achieving with the inclusion criteria. Conclusions: The etiological factors are remembered by the mnemonic of the 4Ts (Tonus, trauma, tissue and thrombin). The uterine atony (uterine tonus disorder) is presented in the 80% of the cases and its management consists in uterine massage, Oxytocin, Methylergonovine and Misoprostol use. Between the non-pharmacological measures are cited the bakri balloon, embolization, hypogastric or uterine arteries ligation, B-Lynch´s surgery and subtotal or total abdominal hysterectomy. The other causes of PPH are the injuries of the channel of the childbirth, the retention of remains and the coagulation disorders, that have specific management. The identification of the etiological factors for PPH allows the early standard for the management, which avoids the morbidity and reduces the mortality. It is fundamental the implementation of institutional protocols. Rev.cienc.biomed.2014;5(2):307-316. KEYWORDS Postpartum hemorrhage; Oxytocin; Methylergonovine; Misoprostol.