Drape estimation vs. visual assessment for estimating postpartum hemorrhage

Patel, Ashlesha; Goudar, Shivaprasad S.; Geller, Stacie E.; Kodkany, Bhala; Edlavitch, Stanley A.; Wagh, K.; Patted, Suresh; Naik, Vijaya A.; Moss, Nancy; Derman, Richard

doi:10.1016/j.ijgo.2006.02.014

Cited by 253 publications

(211 citation statements)

References 11 publications

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“…Collection of lost blood was initiated immediately after birth of the baby by passing a drape under the woman's buttocks. 12 Blood collected in the drape was put in a bucket, weighed on a digital scale together with the drape, and the amount recorded in grams. Trial interventions were administered by the staff who managed the deliveries.…”

Section: Methodsmentioning

confidence: 99%

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Gülmezoglu¹,

Lumbiganon²,

Landoulsi³

et al. 2012

The Lancet

125

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Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial. Lancet, 379 (9827 A Metin Gülmezoglu, Pisake Lumbiganon, Sihem Landoulsi, Mariana Widmer, Hany Abdel-Aleem, Mario Festin, Guillermo Carroli, Zahida Qureshi, João Paulo Souza, Eduardo Bergel, Gilda Piaggio, Shivaprasad S Goudar, John Yeh, Deborah Armbruster, Mandisa Singata, Cristina Pelaez-Crisologo, Fernando Althabe, Peter Sekweyama, Justus Hofmeyr, Mary-Ellen Stanton, Richard Derman, Diana Elbourne SummaryBackground Active management of the third stage of labour reduces the risk of post-partum haemorrhage. We aimed to assess whether controlled cord traction can be omitted from active management of this stage without increasing the risk of severe haemorrhage.

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Section: Methodsmentioning

confidence: 99%

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Gülmezoglu¹,

Lumbiganon²,

Landoulsi³

et al. 2012

The Lancet

125

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“…Blood loss at cesarean is difficult to assess accurately. In a study, visual assessment of blood loss was 33 % less than the drape estimate; with the drape estimate correlating well with photo spectrometry [9]. In the present study to obviate the Table 5 Perioperative morbidity above limitation, perioperative change in Hb between preoperative and the second postoperative day was also done to assess the blood loss indirectly.…”

Section: Discussionmentioning

confidence: 78%

Sublingual Misoprostol to Reduce Blood Loss at Cesarean Delivery

Sood¹,

Singh²

2012

J Obstet Gynecol India

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Objective This prospective randomized controlled study was carried out with the purpose of assessing the efficacy of sublingual misoprostol in decreasing intraoperative blood loss and the need for additional uterotonic agents at cesarean delivery. Methods One hundred seventy-four women undergoing elective or emergency cesarean delivery were assigned randomly to receive either 400 lg misoprostol or placebo sublingually at the time of cord clamping. An intravenous infusion of 20 units of oxytocin was started in all women at the same time. The primary outcome measures were intraoperative blood loss, need for additional uterotonic agents, and perioperative hemoglobin (Hb) fall. Results The maternal demographic factors, indications for cesarean delivery, and high-risk factors were similar between the two groups. Mean intraoperative blood loss was significantly less in misoprostol group as compared with placebo group (595 ± 108 vs. 651 ± 118 ml, P = 0.025). Fewer women needed additional uterotonic agents in misoprostol group (22.2 vs. 42.8 %; P = 0.0035; RR 0.52, 95 % CI 0.33-0.82). Perioperative Hb fall was significantly less in misoprostol group (0.87 ± 0.29 vs. 1.01 ± 0.26 g, P = 0.0018). Conclusion Sublingual misoprostol decreases intraoperative blood loss and the need for additional uterotonic agents at cesarean delivery.

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“…However, prior studies have had mixed results in comparing the accuracy of measured blood loss to quantify methods of blood loss. Patel and colleagues 17 found a positive correlation between measured blood loss and other laboratory methods of measuring blood loss by photo spectrometry. Their study was limited by a relatively small sample size (n = 10).…”

Section: Discussionmentioning

confidence: 97%

The Effectiveness of a Collector Bag for Measurement of Post-partum Hemorrhage

Abbaspoor

Vaziri

2017

Afr J Reprod Health

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The aim of the study was to assess sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of collector bag and its correlation with hemoglobin (Hb) and hematocrit (Ht) variations. This study, carried on 100 women referred for admission to labor ward of Shohada hospital in Orumeyeh City, Iran, from April to November, 2007. Serum Hb and Ht were measured after admission; a collecting bag placed under the pelvis just after birth and was weighted after delivery. Hb and Ht were again assessed at 8 hr after delivery. PPH was defined as blood loss ˃500 ml following vaginal delivery. Each 500 ml blood loss accounts for approximately a 3% change in the Ht level or a falling in Hb of 1 g/dl. With this cut off our noted Sensitivity=80%, Specificity=95. 7%, PPV= 88.9% and NPV= 91.8%. The collector bag is a rapid and precise instrument to diagnose of postpartum hemorrhage in the delivery room. It also enables a visual, quantitative and objective estimation of blood loss. RésuméLe but de l'étude était d'évaluer la sensibilité, la spécificité, la valeur prédictive positive (VPP), la valeur prédictive négative (VPN) du sac collecteur et sa corrélation avec les variations de l'hémoglobine (Hb) et de l'hématocrite (Ht). Cette étude a porté sur 100 femmes envoyées aux spécialistes au service de travail de l'hôpital Shohada dans la ville d'Orumeyeh, en Iran, d'avril à novembre 2007. Les taux de Hb et Ht sériques ont été mesurés après l'admission; Un sac de collecte placé sous le bassin juste après la naissance a été pondéré après l'accouchement. Hb et Ht ont de nouveau été évalués 8 heures après l'accouchement. La PPH a été définie comme une perte de sang ˃500 ml après l'accouchement vaginal. Chaque perte de sang de 500 ml représente approximativement une variation de 3% du niveau Ht ou une baisse de Hb de 1 g / dl. Avec ceci comme point minimum, nous avons noté la Sensitivité = 80%, Spécificité = 95. 7%, VPP = 88,9% et VPN = 91,8%. Le sac collecteur est un instrument rapide et précis pour diagnostiquer une hémorragie post-partum dans la salle d'accouchement. Il permet également une estimation visuelle, quantitative et objective de la perte de sang. (Afr J Reprod Health 2017; 21[1]:99-103).

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Drape estimation vs. visual assessment for estimating postpartum hemorrhage

Abstract: Drape estimation of blood loss is more accurate than visual estimation and may have particular utility in the developing world. Prompt detection of postpartum hemorrhage may reduce maternal morbidity and mortality in low-resource settings.

Cited by 253 publications

References 11 publications

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial

Sublingual Misoprostol to Reduce Blood Loss at Cesarean Delivery

The Effectiveness of a Collector Bag for Measurement of Post-partum Hemorrhage

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