Comparison between gravimetric measurement and visual estimation of postpartum blood loss

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.

Download Full-text

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.

Download Full-text

Visual estimation of postpartum blood loss during a simulation training: A prospective study

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2019.101673 ◽

2020 ◽

Vol 49 (4) ◽

pp. 101673

Author(s):

Juliette Lemée ◽

Aurélien Scalabre ◽

Céline Chauleur ◽

Tiphaine Raia-Barjat

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Simulation Training ◽

Visual Estimation ◽

Postpartum Blood Loss ◽

A Prospective Study

Download Full-text

Accuracy of Blood Loss Measurement during Cesarean Delivery

American Journal of Perinatology Reports ◽

10.1055/s-0037-1601382 ◽

2017 ◽

Vol 07 (02) ◽

pp. e93-e100 ◽

Cited By ~ 16

Author(s):

Sahar Doctorvaladan ◽

Andrea Jelks ◽

Eric Hsieh ◽

Robert Thurer ◽

Mark Zakowski ◽

...

Keyword(s):

Blood Loss ◽

Cesarean Delivery ◽

Gravimetric Method ◽

Assay Method ◽

Visual Estimation ◽

Colorimetric Analysis ◽

Gravimetric Measurement ◽

Colorimetric System ◽

Cesarean Deliveries ◽

Bland Altman Method

Objective This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland–Altman method. Results Compared with the blood loss measured by the reference assay (470 ± 296 mL), the colorimetric system (572 ± 334 mL) was more accurate than either visual estimation (928 ± 261 mL) or gravimetric measurement (822 ± 489 mL). The correlation between the assay method and the colorimetric system was more predictive (standardized coefficient = 0.951, adjusted R2 = 0.902) than either visual estimation (standardized coefficient = 0.700, adjusted R2 = 00.479) or the gravimetric determination (standardized coefficient = 0.564, adjusted R2 = 0.304). Conclusion During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes.

Download Full-text

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

Singapore Medical Journal ◽

10.11622/smedj.2016107 ◽

2015 ◽

Vol 57 (06) ◽

pp. 325-328 ◽

Cited By ~ 13

Author(s):

T Lertbunnaphong ◽

N Lapthanapat ◽

J Leetheeragul ◽

P Hakularb ◽

A Ownon

Keyword(s):

Blood Loss ◽

Visual Estimation ◽

Postpartum Blood Loss ◽

Objective Quantification

Download Full-text

Use of Cholera Beds in the Delivery Room: A Simple and Appropriate Method for Direct Measurement of Postpartum Bleeding

Tropical Doctor ◽

10.1177/004947550303300408 ◽

2003 ◽

Vol 33 (4) ◽

pp. 215-216 ◽

Cited By ~ 7

Author(s):

Roland T Strand ◽

Florinda da Silva ◽

Staffan Bergström

Keyword(s):

Blood Loss ◽

Vaginal Bleeding ◽

Postpartum Haemorrhage ◽

Critical Time ◽

Good Alternative ◽

Active Management ◽

Limited Resources ◽

Visual Estimation ◽

Postpartum Blood Loss ◽

Third Stage

Abundant obstetric bleeding is a predominant cause of maternal death, with the immediate postpartum period being the most critical time. Visual estimation of postpartum haemorrhage (PPH) often leads to severe underestimation and delay in treatment. Various methods have been developed in order to measure blood loss accurately, but none has proved appropriate in poor settings. The aim of this study was to present a method which is appropriate for measuring postpartum blood loss in a setting with limited resources. Parturient women ( n=814) with active management of third stage of labour in Luanda, Angola were studied. Vaginal bleeding immediately after birth and during the first 2 hours postpartum was collected using a combination of a plastic sheet and a bucket below a cholera bed, in which the women rested during postpartum observation. Monitoring postpartum blood loss in the same way as cholera patients are monitored for loss of stool fluid was found to be a useful and practical way of measuring haemorrhage of parturient women after childbirth. The method described here is simple and appropriate, which makes it a good alternative to more costly methods in detecting and quantifying PPH.

Download Full-text