Quantitative blood loss after vaginal delivery: a retrospective analysis of 104 079 measurements at 41 institutions

Objective This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery. Study Design This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage. Results A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79). Conclusion There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery. Key Points

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Predicting the Severity of Pancreatic Fistula after Pancreaticoduodenectomy: Overweight and Blood Loss as Independent Risk Factors: Retrospective Analysis of 277 Patients

Surgical Infections ◽

10.1089/sur.2019.027 ◽

2019 ◽

Vol 20 (6) ◽

pp. 486-491 ◽

Cited By ~ 6

Author(s):

Alban Zarzavadjian Le Bian ◽

David Fuks ◽

Filippo Montali ◽

Manuela Cesaretti ◽

Renato Costi ◽

...

Keyword(s):

Risk Factors ◽

Blood Loss ◽

Pancreatic Fistula ◽

Retrospective Analysis ◽

Independent Risk Factors

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Introduction of a Novel System for Quantitating Blood Loss After Vaginal Delivery: A Retrospective Interrupted Time Series Analysis With Concurrent Control Group

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000693696.14191.c0 ◽

2020 ◽

Vol 40 (3) ◽

pp. 128-129

Author(s):

M. Lumbreras-Marquez ◽

S.C. Reale ◽

D.A. Carusi ◽

J.N. Robinson ◽

N. Scharf ◽

...

Keyword(s):

Time Series ◽

Blood Loss ◽

Time Series Analysis ◽

Vaginal Delivery ◽

Interrupted Time Series ◽

Control Group ◽

Interrupted Time Series Analysis ◽

Concurrent Control ◽

Series Analysis ◽

Concurrent Control Group

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Towards a universal definition of postpartum hemorrhage: retrospective analysis of Chinese women after vaginal delivery or cesarean section

Medicine ◽

10.1097/md.0000000000021714 ◽

2020 ◽

Vol 99 (33) ◽

pp. e21714

Author(s):

Qiang Wei ◽

Yi Xu ◽

Li Zhang

Keyword(s):

Cesarean Section ◽

Retrospective Analysis ◽

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Chinese Women ◽

Universal Definition ◽

Definition Of

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Study of cases of post-partum hemorrhage after spontaneous vaginal delivery in labour room of obstetrics and gynecology department of tertiary care center, Ranchi, Jharkhand, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201219 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1540

Author(s):

Bratati Moitra ◽

Bulllu Priya Oraon

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Maternal Death ◽

Post Partum ◽

Care Center ◽

Tertiary Care ◽

Spontaneous Vaginal Delivery ◽

Lower Middle Class ◽

Threatening Condition ◽

Labour Room

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.

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