Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study

Abstract Background Post-partum hemorrhage (PPH) is the leading cause of obstetric morbidity and mortality around the world. Prophylactic administration of tranexamic acid (TXA) in patients at risk for PPH is aimed at reducing estimated blood loss (EBL). Method This was a prospective cohort study. Patients at high risk of PPH were given 1000mg of TXA intravenously at cord clamping after delivery of the baby, and compared with high PPH risk controls who did not receive TXA. Both cesarean section deliveries (CD) and vaginal deliveries (VD) were included. The primary outcome was postpartum hemorrhage, and the secondary outcome was calculated estimated blood loss (cEBL). Results Between January 2017 and May 2017, 101 patients at high risk for PPH were enrolled. Fifty one received TXA and 50 did not. There were 20 cases of PPH in the TXA group compared with 30 cases in the control group (OR 0.43, 95% CI, NNT=5). The average cEBL for VD and CD were significantly lower in the patients who received TXA compared with controls: 561ml ±336ml compared with 841ml ±462ml (p=0.0006) for VD and 658ml ±294mL compared with 1024ml ±276 for CD (p=0.0007). Conclusions Intravenous TXA may be used as prophylaxis for PPH in obstetric patients at high risk.

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Is there a hidden blood loss in orthognathic surgery and should it be considered? Results of a prospective cohort study

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2020.07.015 ◽

2020 ◽

Cited By ~ 1

Author(s):

Michael Schwaiger ◽

Jürgen Wallner ◽

Sarah-Jayne Edmondson ◽

Irene Mischak ◽

Jasmin Rabensteiner ◽

...

Keyword(s):

Cohort Study ◽

Blood Loss ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Orthognathic Surgery ◽

Hidden Blood Loss

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Effect of intraoperative dexmedetomidine infusion during functional endoscopic sinus surgery: a prospective cohort study

Patient Safety in Surgery ◽

10.1186/s13037-020-00264-4 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Mohammad Reza Fazel ◽

Zeynab Sadat Ahmadi ◽

Hossein Akbari ◽

Fahimeh Abam

Keyword(s):

Cohort Study ◽

Placebo Group ◽

Blood Loss ◽

Prospective Cohort Study ◽

Endoscopic Sinus Surgery ◽

Prospective Cohort ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Significant Difference ◽

Dexmedetomidine Infusion

Abstract Background Dexmedetomidine, an α2 agonist, has well-known anesthetic and analgesic-sparing effects. We designed this study to evaluate the effect of intraoperative dexmedetomidine infusion on intra operative blood loss and postoperative pain in functional endoscopic sinus surgery. Methods This prospective cohort study included 90 patients planning to undergo endoscopic sinus surgery, who were randomly divided into three groups. 2 to 2.5 mg/kg of propofol was used in all groups to induce anesthesia. One group received dexmedetomidine 0.2 μg/kg per hour infusion whereas the other group received dexmedetomidine 0.5 μg/kg per hour infusion. The control group received normal saline infusion. Results The mean age of patients was 41.02 ± 11.93. 33 patients in the dexmedetomidine 0.2 μg/kg/h group, 30 patients in the dexmedetomidine 0.5 μg/kg/h group and 27 patients in the placebo group. The lowest amount of bleeding was related to the dexmedetomidine 0.5 μg/kg/h group. The volume of bleeding between the three groups was significantly different (p = 0.012). The satisfaction of the surgeon in the dexmedetomidine 0.5 μg/kg/h group was more than other groups. There was a significant relationship between the satisfaction of the surgeon and the treatment groups (p < 0.001). The lowest duration of surgery was related to the dexmedetomidine 0.2 μg/kg/h group. The most Trinitroglycerin (TNG) consumption was in the placebo group and the highest dose of labetalol was in the dexmedetomidine 0.5 μg/kg/h group. There was no significant difference in the TNG and labetalol consumption between three groups. The lowest consumption of morphine and pethidine in the dexmedetomidine 0.5 μg/kg/h group. Conclusions Infusion of dexmedetomidine 0.5 μg/kg/h decreased blood loss and consumption of morphine and pethidine in patients who underwent endoscopic sinus surgery.

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Risk Factors for Postpartum Hemorrhage and its Severe Forms with Blood Loss Evaluated Objectively – A Prospective Cohort Study

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1718439 ◽

2021 ◽

Vol 43 (02) ◽

pp. 113-118

Author(s):

Anderson Borovac-Pinheiro ◽

Filipe Moraes Ribeiro ◽

Rodolfo Carvalho Pacagnella

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Blood Loss ◽

Prospective Cohort Study ◽

Postpartum Hemorrhage ◽

Prospective Cohort ◽

Early Recognition ◽

Univariate Analysis ◽

Second Stage Of Labor ◽

Second Stage

Abstract Objective To identify risk factors related to postpartum hemorrhage (PPH) and severe PPH with blood loss quantified objectively. Methods This is a complementary analysis of a prospective cohort study that included pregnant women delivering vaginally. The total blood loss was obtained through the sum of the volume collected from the drape with the weight of gauzes, compresses and pads used by women within 2 hours. Exploratory data analysis was performed to assess mean, standard deviation (SD), frequency, percentage and percentiles. The risk factors for postpartum bleeding were evaluated using linear and logistic regression. Results We included 270 women. The mean blood loss at 120 minutes was 427.49 mL (±335.57 mL). Thirty-one percent (84 women) bled > 500 mL and 8.2% (22 women) bled > 1,000 mL within 2 hours. Episiotomy, longer second stage of labor and forceps delivery were related to blood loss > 500 mL within 2 hours, in the univariate analysis. In the multivariate analysis, only forceps remained associated with bleeding > 500 mL within 2 hours (odds ratio [OR] = 9.5 [2.85–31.53]). Previous anemia and episiotomy were also related to blood loss > 1,000mL. Conclusion Prolonged second stage of labor, forceps and episiotomy are related to increased incidence of PPH, and should be used as an alert for the delivery assistants for early recognition and prompt treatment for PPH.

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