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

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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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

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Comparison between gravimetric measurement and visual estimation of postpartum blood loss

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild.2011.300162.38 ◽

2011 ◽

Vol 96 (Supplement 1) ◽

pp. Fa86-Fa86

Author(s):

P. J. Dutton ◽

S. Vause ◽

R. A. Samangaya

Keyword(s):

Blood Loss ◽

Visual Estimation ◽

Gravimetric Measurement ◽

Postpartum Blood Loss

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

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/922/1/012071 ◽

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.

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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.

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