scholarly journals Comparisons among measurement approaches to determine blood loss with different environmental sanitary effects

2021 ◽  
Vol 922 (1) ◽  
pp. 012071
Author(s):  
Sulastri ◽  
T N Siregar ◽  
M Adlim ◽  
Hasanuddin
Keyword(s):  
Literature Review ◽  
Blood Loss ◽  
Maternal Death ◽  
Postpartum Hemorrhage ◽  
Measurement Methods ◽  
Visual Estimation ◽  
Loss Measurement ◽  
Online Databases ◽  
Keyword Searches ◽  
Objective Quantification

Abstract Labour and delivery are hazardous processes for bleeding. It will have complications, and even death for maternal because of overdue recognition and identification of the early signs of bleeding. Postpartum hemorrhage is still a problem and a major cause of maternal death. The definition, bleeding threshold, and method of assessing blood loss are still being debated today. This literature review aimed to determine the methods that had been used in measuring the amount of blood loss and risk to the mother. The review used Science Direct and Pubmed electronic online databases with related keyword searches. Measurement of blood loss was categorized into several methods, including visual estimation, direct measurement, gravimetry, and photometry. These methods were explained and then compared with various similar methods. Several studies indicated that measuring the amount of blood loss still often used conventional methods, even though this method was very improper and tends to underestimate blood loss. Several accurate and objective quantification methods had been introduced, but they were still very complicated, expensive, and time-consuming. Based on the review results, various types of blood loss measurement methods were displayed, but they were still not practical, accurate, and reliable. Researchers continue to carry out improvement research in finding methods so that postpartum hemorrhage can be prevented and treated.

scholarly journals The Accuracy of Postpartum Blood Loss Estimation Using Plastic Collector Bag and Visual Estimation at Ramathibodi Hospital

2019 ◽  
Vol 42 (3) ◽  
pp. 48-56
Author(s):  
Sirikanya Phaikaew ◽  
Sophaphan Ploungbunmee
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Accurate Estimation ◽  
Fisher Exact Test ◽  
Visual Estimation ◽  
Loss Assessment ◽  
Exact Test ◽  
Postpartum Blood Loss ◽  
Quasi Experimental ◽  
The Difference

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.

The validity of Visual Blood Loss Estimation in Postpartum Hemorrhage in Shanghai Hospitals: A Web-based Survey (Preprint)

2019 ◽  
Author(s):  
Ying Liu ◽  
Weiwei Cheng ◽  
Ying Shen ◽  
Lin Rao ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Descriptive Analysis ◽  
Mainland China ◽  
Visual Estimation ◽  
Chi Square ◽  
Cross Sectional ◽  
Estimated Blood Loss ◽  
Tertiary Hospitals ◽  
Chi Square Test

BACKGROUND Postpartum Hemorrhage has been recognized as the most fatal factor in maternal death. Yet midwives can barely distinguish whether the blood loss has reached a life-threatening amount without precise measurement, particularly during a slow hemorrhage. Also, understaffed midwives in mainland China adds to the difficulty of timely accurate measurement of blood loss. OBJECTIVE To evaluate the accuracy of visual estimated blood loss in postpartum hemorrhage by clinical midwives, as well as the reproducibility of the visual estimation and influencing factors on accuracy. METHODS With a modified on-line visual estimation questionnaire of blood loss, a cross-sectional multicenter study was conducted among voluntary midwives or obstetrical nurses engaged in clinical practice in secondary and tertiary hospitals in Shanghai. A descriptive analysis was performed with demographic features and the rate of accurate responses. The Kappa coefficient was employed to determine the reproducibility of the agreement of visual estimation. The correlations between demographics and items of the questionnaire were conducted with Chi-square test and Spearman correlation analysis. RESULTS A total of 281 midwives and nurses participated in the survey. The finding showed relatively low accuracy and reproducibility of visual estimation, with 25.6% and 17.8% subjects in Shanghai hospitals distinguishing the postpartum hemorrhage (500ml) and the severe postpartum hemorrhage (1000ml), respectively. The Kappa coefficients were slight to moderate (0.062~0.450). The institutional routine for blood loss calculation turned out to be relevant to the accuracy of visual estimation. CONCLUSIONS Visual estimation cannot provide sound validity for blood loss evaluation in postpartum hemorrhage in China, especially when the amount exceeds 500ml. Institutions should make routines on how blood loss can be reckoned with the sterile drapes and gauzes they use, and provide regular training for midwives and nurses.

scholarly journals Postpartum blood loss: visual estimation versus objective quantification with a novel birthing drape

2015 ◽  
Vol 57 (06) ◽  
pp. 325-328 ◽  
Author(s):  
T Lertbunnaphong ◽  
N Lapthanapat ◽  
J Leetheeragul ◽  
P Hakularb ◽  
A Ownon
Keyword(s):  
Blood Loss ◽  
Visual Estimation ◽  
Postpartum Blood Loss ◽  
Objective Quantification

scholarly journals Postpartum hemorrhage in Suriname: A national descriptive study of hospital births and an audit of case management

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244087
Author(s):  
Lachmi R. Kodan ◽  
Kim J. C. Verschueren ◽  
Zita D. Prüst ◽  
Nicolaas P. A. Zuithoff ◽  
Marcus J. Rijken ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Early Recognition ◽  
Multiple Pregnancy ◽  
Descriptive Study ◽  
Active Management ◽  
Risk Indicators ◽  
National Guidelines ◽  
Loss Measurement

Background Postpartum hemorrhage (PPH) is the leading cause of direct maternal mortality globally and in Suriname. We aimed to study the prevalence, risk indicators, causes, and management of PPH to identify opportunities for PPH reduction. Methods A nationwide retrospective descriptive study of all hospital deliveries in Suriname in 2017 was performed. Logistic regression analysis was applied to identify risk indicators for PPH (≥ 500ml blood loss). Management of severe PPH (blood loss ≥1,000ml or ≥500ml with hypotension or at least three transfusions) was evaluated via a criteria-based audit using the national guideline. Results In 2017, the prevalence of PPH and severe PPH in Suriname was 9.2% (n = 808/8,747) and 2.5% (n = 220/8,747), respectively. PPH varied from 5.8% to 15.8% across the hospitals. Risk indicators associated with severe PPH included being of African descent (Maroon aOR 2.1[95%CI 1.3–3.3], Creole aOR 1.8[95%CI 1.1–3.0]), multiple pregnancy (aOR 3.4[95%CI 1.7–7.1]), delivery in Hospital D (aOR 2.4[95%CI 1.7–3.4]), cesarean section (aOR 3.9[95%CI 2.9–5.3]), stillbirth (aOR 6.4 [95%CI 3.4–12.2]), preterm birth (aOR 2.1[95%CI 1.3–3.2]), and macrosomia (aOR 2.8 [95%CI 1.5–5.0]). Uterine atony (56.7%, n = 102/180[missing 40]) and retained placenta (19.4%, n = 35/180[missing 40]), were the main causes of severe PPH. A criteria-based audit revealed that women with severe PPH received prophylactic oxytocin in 61.3% (n = 95/155[missing 65]), oxytocin treatment in 68.8% (n = 106/154[missing 66]), and tranexamic acid in 4.9% (n = 5/103[missing 117]). Conclusions PPH prevalence and risk indicators in Suriname were similar to international and regional reports. Inconsistent blood loss measurement, varied maternal and perinatal characteristics, and variable guideline adherence contributed to interhospital prevalence variation. PPH reduction in Suriname can be achieved through prevention by practicing active management of the third stage of labor in every birth and considering risk factors, early recognition by objective and consistent blood loss measurement, and prompt treatment by adequate administration of oxytocin and tranexamic acid according to national guidelines.

TO EVALUATE THE EFFECTIVENESS OF CONDOM BALLOON CATHETER IN TREATING INTRACTABLE POSTPARTUM HEMORRHAGE AT KONTUM PROVINCIAL HOSPITAL

2018 ◽  
Vol 8 (6) ◽  
pp. 178-183
Author(s):  
Dinh Nguyen Gia ◽  
Thanh Cao Ngoc
Keyword(s):  
Maternal Death ◽  
Postpartum Hemorrhage ◽  
Medical Management ◽  
Balloon Catheter ◽  
Uterine Atony ◽  
Cross Sectional ◽  
Common Cause ◽  
Provincial Hospital ◽  
Balloon Tamponade ◽  
Condom Catheter

Background: Postpartum hemorrhage (PPH) remains a significant contributor to maternal morbility and mortality and accounts for 31% of maternal death in Vietnam. The most common cause of PPH is uterine atony. Recently, uterine tamponade using intrauterine condom appears to be an effective tool in the management of intractable PPH. Objectives: To evaluate the success of condom as a tamponade to arrest intractable PPH due to uterine atony in patients not responding to medical management. Materials and Methods: The study was designed as a cross-sectional and descriptive, included 32 patients who underwent condom balloon tamponade at Kontum Provincial Hospital from 1/2012 to 8/2016. Results: 32 women (mean age 25.71 ± 6.45 years range, 16 - 39) underwent condom balloon tamponade for PPH controls. 29 patients (90.62%) successfully responded the tamponade therapy by the use of condom catheter. Three patients (9.37%) required hysterectomy. Conclusions: Condom catheter balloon effectively controls the intractable PPH due to uterine atony. Key words: PPH (Pospartum hemorrhage), Tamponade, Condom catheter balloon, Uterine atony

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

The Impact of Obesity on the Management and Outcomes of Postpartum Hemorrhage

2020 ◽  
Author(s):  
Aleksandra Polic ◽  
Tierra L. Curry ◽  
Judette M. Louis
Keyword(s):  
Interventional Radiology ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Tertiary Care ◽  
P Value ◽  
Obese Women ◽  
Severe Morbidity ◽  
The Impact ◽  
To Receive

Objective The study aimed to evaluate the impact of obesity on the management and outcomes of postpartum hemorrhage. Study Design We conducted a retrospective cohort study of women who delivered at a tertiary care center between February 1, 2013 and January 31, 2014 and experienced a postpartum hemorrhage. Charts were reviewed for clinical and sociodemographic data, and women were excluded if the medical record was incomplete. Hemorrhage-related severe morbidity indicators included blood transfusion, shock, renal failure, transfusion-related lung injury, cardiac arrest, and use of interventional radiology procedures. Obese (body mass index [BMI] ≥ 30 kg/m2) and nonobese women were compared. Data were analyzed using Chi-square, Student's t-test, Mann–Whitney U test, and linear regression where appropriate. The p-value <0.05 was significant. Results Of 9,890 deliveries, 2.6% (n = 262) were complicated by hemorrhage. Obese women were more likely to deliver by cesarean section (55.5 vs. 39.8%, p = 0.016), undergo a cesarean after labor (31.1 vs. 12.2%, p = 0.001), and have a higher quantitative blood loss (1,313 vs. 1,056 mL, p = 0.003). Both groups were equally likely to receive carboprost, methylergonovine, and misoprostol, but obese women were more likely to receive any uterotonic agent (95.7 vs. 88.9%, p = 0.007) and be moved to the operating room (32.3 vs. 20.4, p = 0.04). There was no difference in the use of intrauterine pressure balloon tamponade, interventional radiology, or decision to proceed with hysterectomy. The two groups were similar in time to stabilization. There was no difference in the need for blood transfusion. Obese women required more units of blood transfused (2.2 ± 2 vs. 2 ± 5 units, p = 0.023), were more likely to have any hemorrhage-related severe morbidity (34.1 vs. 25%, p = 0.016), and more than one hemorrhage related morbidity (17.1 vs. 7.9, p = 0.02). After controlling for confounding variables, quantitative blood loss, and not BMI was predictive of the need for transfusion. Conclusion Despite similar management, obese women were more likely to have severe morbidity and need more units of blood transfused. Key Points

scholarly journals Interventions and Management of Postpartum Hemorrhage: A Literature Review

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Dida Rosida ◽  
Yanti Hermayanti ◽  
Sukmawati S
Keyword(s):  
Literature Review ◽  
Postpartum Hemorrhage

scholarly journals A comprehensive digital phenotype for postpartum hemorrhage

2021 ◽  
Author(s):  
Amanda B Zheutlin ◽  
Luciana Vieira ◽  
Shilong Li ◽  
Zichen Wang ◽  
Emilio Schadt ◽  
...  
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Chart Review ◽  
Diagnostic Codes ◽  
Treatment Data ◽  
Selected Subset ◽  
And Performance ◽  
Preventative Interventions ◽  
Surgical Treatments ◽  
Current Guidelines

ABSTRACTObjectiveWe aimed to establish a comprehensive digital phenotype for postpartum hemorrhage (PPH). Current guidelines rely primarily on estimates of blood loss, which can be inaccurate and biased, and ignore a suite of complementary information readily available in electronic medical records (EMR). Inaccurate and incomplete phenotyping contribute to ongoing challenges to track PPH outcomes, develop more accurate risk assessments, and identify novel interventions.MethodsWe constructed a cohort of 71,944 deliveries from the Mount Sinai Health System, 2011-2019. Estimates of postpartum blood loss, shifts in hematocrit intra- and postpartum, administration of uterotonics, surgical treatments, and associated diagnostic codes were combined to identify PPH retrospectively. All clinical features were extracted from structured EMR data and mapped to common data models for maximum interoperability across hospitals. Blinded chart review was done on a randomly selected subset of cases and controls for validation and performance was compared to alternate PPH phenotypes.ResultsWe identified 6,639 cases (9% prevalence) using our phenotype – more than three times as many as using blood loss alone (N=1,747), supporting the need to incorporate other diagnostic and treatment data. Blinded chart review revealed our phenotype had 96% sensitivity, 89% precision, 77% specificity, and 89% accuracy to detect PPH. Alternate phenotypes were less accurate, including a common blood loss-based definition (67%) and a previously published digital phenotype (74%).ConclusionWe have developed a scalable, accurate, and valid digital phenotype that may be of significant use for tracking outcomes and ongoing clinical research to deliver better preventative interventions for PPH.

Sign in / Sign up

Export Citation Format

Share Document