scholarly journals Quantification of Blood Loss Improves Detection of Postpartum Hemorrhage and Accuracy of Postpartum Hemorrhage Rates: A Retrospective Cohort Study

Cureus ◽  
2021 ◽  
Author(s):  
Colleen Blosser ◽  
Alisha Smith ◽  
Aaron T Poole
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort

scholarly journals Retrospective Cohort Study Comparing Current Third Stage Management to Expedient Squatting Third Stage Management

2021 ◽  
Author(s):  
Judy Slome Cohain ◽  
Rina Buxbaum
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Active Management ◽  
Stage Management ◽  
Inclusion Criteria ◽  
Manual Removal ◽  
Third Stage

Abstract Background: Active management of the delivery of the placenta results in 5% postpartum hemorrhage, 1% blood transfusions and an average blood loss of 500 cc. Shorter third stages are associated with decreased hemorrhage rates. The third stage can be shortened by instructing the birthing woman to squat and push out the placenta at 3 minutes postpartum. The objective of this study was to compare blood loss and PPH rates using Judy's 3,4,5 minute third stage expedient squatting protocol to variations of active and expectant third stage management among similar populations.Methodology: A retrospective cohort study was carried out comparing 1,098 planned homebirths attended in Israel, in which Judy’s 3,4,5 expedient squatting third stage technique was practiced, to 2,899 planned homebirths attended by midwives in British Columbia, Canada, where currently accepted third stage management was used. The inclusion criteria for both groups were: Singleton fetus in cephalic presentation; gestational age 37+0 to 41+6 weeks; spontaneous onset of labor; history of up to one previous cesarean; absence of significant pre-existing disease and absence of significant disease arising during pregnancy. The main outcomes were postpartum hemorrhage and manual removal of the placenta. Results: Using identical inclusion criteria and similar management, variations of active and expectant management resulted in 4% PPH over 1000 cc and 1.0% manual removal. Expedient squatting resulted in 2/1098 cases of PPH>500 cc, zero cases of PPH over 1000 cc and 0.7% manual removal. Conclusion: Judy’s 3,4,5 minute third stage management minimizes postpartum bleeding compared to other third stage protocols, reproducing postpartum hemorrhage rates indigenous to primates.

scholarly journals The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0187555 ◽  
Author(s):  
Ada Gillissen ◽  
Dacia D. C. A. Henriquez ◽  
Thomas van den Akker ◽  
Camila Caram-Deelder ◽  
Merlijn Wind ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Maternal Outcome

scholarly journals Comparison Between Bilateral Simultaneous Total Hip Arthroplasty With and Without Drainage; a Retrospective Cohort Study

2021 ◽  
Author(s):  
Min-Gwang Kim ◽  
Taek-Rim Yoon ◽  
Kyung-Soon Park
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Postoperative Bleeding ◽  
Total Blood Loss ◽  
Postoperative Blood Loss ◽  
Consecutive Series ◽  
Transfusion Rate ◽  
Total Blood

Abstract BackgroundThere are many reports staged bilateral THA without drainage is a better method than with drainage in many ways. However, there is little report regarding bilateral simultaneous THA (BSTHA) without drainage. This study aimed to evaluate the differences in the clinical outcomes and complication rate of BSTHA with drainage and without drainage.MethodsBetween October 2015 and April 2019, a retrospective cohort study was conducted with modified minimally invasive two-incision method and a consecutive series of 41 BSTHA performed with drainage were compared to 37 BSTHA performed without drainage. It was assessed clinically and radiographically for a mean of 2.1 ± 0.8 years (range, 1.0-4.8 years). Postoperative hematologic values (Hgb drop, Hct drop, total blood loss, transfusion rate), pain susceptibility, functional outcome, and complication were compared in the drained group and the non-drained group. All patients preoperatively received intravenous tranexamic acid (TXA) and intraoperatively received intra-articular TXA on each hip. Statistical analyses were performed using the independent t tests, Chi-squared or Fisher’s exact tests. A significance level of ≤ 0.05 was used for all statistical tests.Results Mean postoperative Hgb (g/dL, p < 0.001) & Hct drop (%, p < 0.001), mean total blood loss (ml, p < 0.001) and mean transfusion unit (IU, p < 0.001) were significantly lower in the BSTHA without drainage than in the BSTHA with drainage group. But the mean dose of morphine equivalent (mg, p < 0.001) was significantly larger in BSTHA without drainage.ConclusionBSTHA without drainage can reduce postoperative blood loss and the requirement for transfusion without increasing other complication. But BSTHA without drainage is more painful method than BSTHA with drainage. Therefore, BSTHA without drainage will be a good option to reduce the burden on the patient by reducing postoperative bleeding if it can control pain well after surgery.

Blood type and postpartum hemorrhage by mode of delivery: A retrospective cohort study

2021 ◽  
Vol 256 ◽  
pp. 348-353
Author(s):  
Julia E Burd ◽  
Johanna A Quist-Nelson ◽  
Sara E Edwards ◽  
Anju Suhag ◽  
Vincenzo P Berghella ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Mode Of Delivery ◽  
Blood Type

scholarly journals Coagulation parameters during the course of severe postpartum hemorrhage: a nationwide retrospective cohort study

2018 ◽  
Vol 2 (19) ◽  
pp. 2433-2442 ◽  
Author(s):  
Ada Gillissen ◽  
Thomas van den Akker ◽  
Camila Caram-Deelder ◽  
Dacia D. C. A. Henriquez ◽  
Kitty W. M. Bloemenkamp ◽  
...  
Keyword(s):  
Cohort Study ◽  
Platelet Count ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
Coagulation Parameters ◽  
Early Postpartum ◽  
Prolonged Aptt ◽  
The Moment

Abstract We describe the pattern of change in coagulation parameters during the course of severe postpartum hemorrhage in a retrospective cohort study among 1312 women experiencing severe postpartum hemorrhage necessitating blood transfusion. Levels of hemoglobin, hematocrit, platelet count, fibrinogen, activated partial thromboplastin time (aPTT) and prothrombin time (PT) per categorized volume of blood loss during severe postpartum hemorrhage were described and compared between women with and without the composite adverse outcome. Need for surgical intervention, severe acute maternal morbidity, and maternal mortality were jointly considered the composite adverse outcome. Of the 1312 women, 463 (35%) developed the composite adverse outcome. The incidence of a fibrinogen level &lt;2 g/L was 26% (342 per 1312). Low fibrinogen and prolonged aPTT during the first 2 L of hemorrhage were associated with a subsequent composite adverse outcome; median fibrinogen and aPTT among women with and without the composite end point after 1.5 to 2 L of hemorrhage were 1.5 g/L (interquartile range [IQR], 1.0-1.9) vs 2.7 g/L (IQR, 1.9-3.4) and 39 s (IQR, 30-47) vs 32 s (IQR, 28-36), respectively. PT and platelet count as assessed during the first 2 L of hemorrhage were not associated with morbidity or mortality. Our results suggest that detection of low levels of fibrinogen and elevated aPTT levels during early postpartum hemorrhage can contribute to the identification of women that may benefit from targeted hemostatic treatment. Essential in this identification process is the moment of reaching a level of fibrinogen of &lt;2 g/L during the course of postpartum hemorrhage.

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