The more you lose the more you miss: accuracy of postpartum blood loss visual estimation. A systematic review of the literature

Background: Postpartum hemorrhage is a common cause of maternal death. Accurate estimation of postpartum blood loss is important to help parturients before crisis. Objectives: To compare estimation of postpartum blood loss and proportion of postpartum hemorrhage between plastic collector bag and visual estimation. Methods: This study is quasi-experimental design. Participants were 20 singleton parturients, gestational age at 34 - 40 weeks and without complications during pregnancy who delivered at Ramathibodi Hospital. T test was used for comparing the difference of blood loss with Fisher exact test employed for calculating the proportion of parturients postpartum hemorrhage. The Bland-Altman method was used to determine the level of agreement between methods. Results: Postpartum blood loss collected via a plastic collector bag was significantly more than the visual estimation (P < .05). The mean difference of postpartum blood loss between 2 methods was 112.25 with 95% confidence limits of agreement between -212.15 and 436.66. Conclusions: The plastic collector bag was more accurate in blood loss assessment than visual estimation. It can provide early care and prevention of complications that may occur with parturients.

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Measurement of Postpartum Blood Loss Using a New Two - Set Liquid Collection Bag for Vaginal Delivery: A Prospective, Randomized, Case Control Study

10.21203/rs.3.rs-41858/v1 ◽

2020 ◽

Author(s):

Fang Wang ◽

Nanjia Lu ◽

Xiaofeng Weng ◽

Yanping Tian ◽

Shiwen Sun ◽

...

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Case Control Study ◽

Case Control ◽

Hemoglobin Level ◽

Control Group ◽

Visual Estimation ◽

Postpartum Blood Loss ◽

Experimental Group ◽

Control Study

Abstract Background Postpartum hemorrhage (PPH) is a major obstetric complication, and the real-time measurement of blood loss is important in the management and treatment of PPH. We designed a new two-set liquid collection bag (TSLCB) for measuring postpartum blood loss in vaginal delivery. The aim of this study was to evaluate the effectiveness of the TSLCB in separating the blood from the amniotic fluid during vaginal delivery and in determining the accuracy of the measured postpartum blood loss.Methods A prospective, randomized, case control study was conducted in the Women’s Hospital, Zhejiang University School of Medicine, from March 2018 to April 2018. Sixty single pregnant women with spontaneous labor at 37–41 weeks without maternal complications were randomly divided into the experimental and control groups. The TSLCB was used to evaluate separately the amount of blood and amniotic fluid. For the control group, visual estimation and traditional plastic blood-collecting consumables were used to estimate the amount of postpartum blood loss. The measured blood loss between the two groups was compared, and the association of the measured blood loss with various clinical lab indices and vital signs was investigated. Results The TSLCB (the experimental group) improved the detection of the measured blood loss compared with visual estimation and the traditional method (the control group) (p < 0.05). In the experimental group, correlation analysis showed that the measured blood loss at delivery and within 24 h of delivery was significantly associated with the decreased hemoglobin level, red blood cell count, and hematocrit level of patients (r = -0.574, -0.455, -0.437; r = 0.-595, -0.368, -0.374; p < 0.05). In the control group, only the measured blood loss within 24 h of delivery was associated with the decreased hemoglobin level (r = -0.395, p < 0.05). No blood transfusion and plasma expanders were required in the treatment of PPH for both groups.Conclusions The TSLCB can be used to accurately measure the postpartum blood loss in vaginal delivery by medical personnel.Trial registration: This trial was registered with Chinese Clinical Trial Registry (ChiCTR): ChiCTR-IOR-17012453, 23 August 2017.

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