Noninvasive prenatal screening has significantly changed the practice of prenatal screening. However, while increasing the detection of Down syndrome, the concomitant decrease in DP and lack of aCGH results in missing many more abnormalities than the increase in Down syndrome and complications of DP combined. From a public health perspective, such represents a missed opportunity for overall health care delivery.

The device identified hemorrhages more frequently than visual estimation. Device-detected hemorrhages appeared clinically relevant. Blood product transfusion was reduced possibly due to earlier recognition and treatment, although further studies are needed to verify the conclusion.

Key Points

INTRODUCTION: The need for red blood cell transfusion for patients having cesarean delivery is ideally based on an evaluation of both clinical indicators and laboratory studies. In practice, transfusions are often given to women based on estimated intraoperative blood loss (EBL) and/or the postoperative hemoglobin level. Since visual estimation is known to be inaccurate, we postulated that a more accurate determination using a novel colorimetric device would be better correlated with postoperative day one hemoglobin than visual estimation. METHODS: A formula incorporating both height and weight was used to estimate blood volume and, by including preoperative hemoglobin, red cell mass. Assuming a constant blood volume either the visual EBL (n=32) or EBL using a novel colorimetric device (Triton System™, Gauss Surgical) that incorporates a mobile application to photograph sponges and canisters and calculate their hemoglobin content (n=53) was used to predict the postoperative day one hemoglobin value in patients where either the visual estimate or colorimetric estimate was >1,000 ml (a common definition of hemorrhage). RESULTS: The predicted postoperative day one hemoglobin level using the device was better correlated with the actual value (R squared=0.319) than the predictions using visual EBL (R squared=0.035) (P=.027). CONCLUSION: In mothers with high blood loss, EBL using the novel device was a more accurate predictor of the postoperative day one hemoglobin than visually estimated blood loss. Clinical use of this information has the potential to improve transfusion practice in cesarean delivery patients and positively impact maternal health.