A comparative study of Brass-V Drape and standardised visual estimation of blood loss during vaginal delivery – a single-observer 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

Standardized Visual Estimation of Blood Loss during Vaginal Delivery with its Correlation Hematocrit Changes—A Descriptive Study

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1040 ◽

2009 ◽

Vol 1 (1) ◽

pp. 29-34 ◽

Cited By ~ 2

Author(s):

MB Bellad ◽

BV Laxmi ◽

SS Goudar ◽

Ashwath Kumar

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Estimate Blood Loss ◽

Descriptive Study ◽

Total Blood Loss ◽

Visual Estimation ◽

Total Blood ◽

Trained Observer ◽

Visual Method ◽

Estimated Blood Loss

ABSTRACT Introduction Postpartum hemorrhage is a leading cause of maternal morbidity and mortality. Traditionally, visual method with variations in accuracy is followed, because it is quick, simple and noninvasive. To rely on this method accuracy is of vital importance. This study was aimed to improve accuracy of visual estimation of blood loss during vaginal delivery by standardizing (using similar sized mops and a fixed container) and correlating with hematocrit changes. Methods design A descriptive study. Sample size 250 women. Single fixed collecting container and similar sized mops were used in the third stage of labor. Blood was drained into the container and was visually calibrated by a single trained observer. The soaking characteristics of the mops were used to estimate total blood loss. Blood spillage on delivery table, garments and floor were approximately assessed. Total blood loss was calculated from the above three sources. Hemoglobin and hematocrit measurements were done at the time of admission and, at 24 and 72 hours postpartum and its correlation was done with blood loss. Analysis By paired and unpaired ‘t’ test. Results 250 out of 269 women completed the study. Incidence of PPH (> 500 ml) was 11.2%. The estimated blood loss correlated well with the hemoglobin and hematocrit changes postpartum. Conclusion Standardized visual method (fixed container and mops) with trained observer improves the accuracy of estimation. This may assist clinicians to accurately estimate blood loss thus preventing hemorrhage related complications.

Download Full-text

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/645 ◽

2021 ◽

Vol 8 (41) ◽

pp. 3559-3566

Author(s):

Abdul Salam R. T. ◽

Shahul Hameed A. ◽

Meera Rajan

Keyword(s):

Blood Loss ◽

Comparative Study ◽

Tertiary Care ◽

Operation Time ◽

Care Hospital ◽

Adenoid Tissue ◽

Significant Difference ◽

Tube Function ◽

Prospective Comparative Study ◽

The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Download Full-text

A Comparative Study of Vaginal Delivery Versus Caesarean Section In Primigravida with Eclampsia After 34 Weeks of Pregnancy.

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-1601044954 ◽

2017 ◽

Vol 16 (01) ◽

pp. 49-54

Author(s):

Swaralipi Misra ◽

Swapan Das ◽

Debjani Deb ◽

Biswajit Mahapatra ◽

Anindya Kumar Das

Keyword(s):

Caesarean Section ◽

Comparative Study ◽

Vaginal Delivery

Download Full-text

A Comparative Study to Assess the Level of Anxiety among Primi Gravida Mothers Planned for Normal Vaginal Delivery and Caesarean Section in the Selected Hospital, Agartala, West Tripura

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210412 ◽

2021 ◽

Vol 6 (2) ◽

pp. 58-61

Author(s):

Ishita Nath

Keyword(s):

Caesarean Section ◽

Comparative Study ◽

Vaginal Delivery ◽

Demographic Variable ◽

Demographic Data ◽

Sampling Technique ◽

Normal Vaginal Delivery ◽

Research Approach ◽

Perinatal Anxiety ◽

Anxiety Screening

A comparative study was conducted among 100 primi gravida mothers (50 mothers in each group) from MCH clinic and IPD of IGM hospital, Agartala, West Tripura, who had planned for normal vaginal delivery and caesarean section. Research approach used was non experimental quantitative approach and research design was descriptive comparative design. Purposive sampling technique was used to draw the sample. Socio demographic data and modified Perinatal Anxiety Screening Scale were used to collect data from the samples through interview method. Analysis revealed that 52% of the primi gravida who had planned for caesarean section and 44% mothers who had planned for normal vaginal delivery had mild symptoms of anxiety. Mean anxiety score of the mothers who planned for caesarean section and normal vaginal delivery was 27.3 and 19.7 respectively, median 28.855 and 18.915 respectively and SD 7.0715 and 8.038 respectively. The mean difference was 7.6 and unpaired ‘t’ value was 5.0198, which was significant at p<0.05. Analysis of variance result showed that there was significant association between the level of anxiety of the primi gravida mothers who had planned for caesarean section with their selected socio demographic variable ‘occupation of husband’. The calculated ‘F’ value was 3.33 at p<0.05. The researcher concluded that the primi gravida mothers who had planned for caesarean section had more anxiety than the mothers who had planned for normal vaginal delivery and the anxiety level of the mothers who had planned for caesarean section was dependent on selected demographic variable occupation of the husband. Keywords:Anxiety, primi gravida, normal vaginal delivery, caesarean section.

Download Full-text

Comparison of measured and calculated postpartum blood loss after vaginal delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.11.931 ◽

2022 ◽

Vol 226 (1) ◽

pp. S562-S563

Author(s):

Hugo Madar ◽

Loïc Sentilhes ◽

François Goffinet ◽

Marie-Pierre Bonnet ◽

Patrick Rozenberg ◽

...

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Postpartum Blood Loss

Download Full-text

Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery

New England Journal of Medicine ◽

10.1056/nejmoa1800942 ◽

2018 ◽

Vol 379 (8) ◽

pp. 731-742 ◽

Cited By ~ 43

Author(s):

Loïc Sentilhes ◽

Norbert Winer ◽

Elie Azria ◽

Marie-Victoire Sénat ◽

Camille Le Ray ◽

...

Keyword(s):

Blood Loss ◽

Tranexamic Acid ◽

Vaginal Delivery

Download Full-text

Effect of Sustained Uterine Compression versus Uterine Massage on Blood Loss after Vaginal Delivery: A Randomized Controlled Trial

American Journal of Perinatology ◽

10.1055/s-0041-1739409 ◽

2021 ◽

Author(s):

Labib M. Ghulmiyyah ◽

Alaa El-Husheimi ◽

Ihab M. Usta ◽

Cristina Colon-Aponte ◽

Ghina Ghazeeri ◽

...

Keyword(s):

Blood Loss ◽

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Primary Outcome ◽

Dropout Rate ◽

Significant Difference ◽

Uterine Massage ◽

Secondary Outcomes ◽

Group 2 ◽

Group 1

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

Download Full-text