Measurement of blood loss during postpartum haemorrhage

Lilley, Graeme; Burkett-st-Laurent, D.; Precious, Elizabeth; Bruynseels, Daniel; Kaye, A.; Sanders, Julia; Alikhan, Raza; Collins, Peter William; Hall, Judith Elizabeth; Collis, Rachel

doi:10.1016/j.ijoa.2014.07.009

Cited by 77 publications

(77 citation statements)

References 18 publications

(21 reference statements)

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“…38–41 Determining whether and how blood loss measurements influence clinical practice is challenging. In a high-quality systematic review of studies that evaluated methods of blood loss assessment, Hancock et al 42 concluded that improved accuracy of blood loss measurement does not facilitate earlier recognition of PPH or prevent progression to more severe PPH.…”

Section: Discussionmentioning

confidence: 99%

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

Shaylor

Weiniger

Austin

et al. 2017

Anesthesia &Amp; Analgesia

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In developed countries, rates of postpartum hemorrhage (PPH) requiring transfusion have been increasing. As a result, anesthesiologists are being increasingly called upon to assist with the management of patients with severe PPH. First responders, including anesthesiologists, may adopt Patient Blood Management (PBM) recommendations of national societies or other agencies. However, it is unclear whether national and international obstetric societies’ PPH guidelines account for contemporary PBM practices. We performed a qualitative review of PBM recommendations published by the following national obstetric societies and international groups: the American College of Obstetricians and Gynecologists; The Royal College of Obstetricians and Gynecologists, United Kingdom; The Royal Australian and New Zealand College of Obstetricians and Gynecologists; The Society of Obstetricians and Gynecologists of Canada; an interdisciplinary group of experts from Austria, Germany, and Switzerland; an international multidisciplinary consensus group; and the French College of Gynaecologists and Obstetricians. We also reviewed a PPH bundle, published by The National Partnership for Maternal Safety. On the basis of our review, we identified important differences in national and international societies’ recommendations for transfusion and PBM. In the light of PBM advances in the nonobstetric setting, obstetric societies should determine the applicability of these recommendations in the obstetric setting. Partnerships among medical, obstetric, and anesthetic societies may also help standardize transfusion and PBM guidelines in obstetrics.

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Section: Discussionmentioning

confidence: 99%

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

Shaylor

Weiniger

Austin

et al. 2017

Anesthesia &Amp; Analgesia

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“…The percent of inaccuracy also increases as the volume of blood loss increases10. The collector bag is an objective tool used to estimate blood loss with an accuracy of 90%9131415. It has been used several times in international randomized controlled clinical trials as the primary endpoint to objectively assess PPH161718.…”

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confidence: 99%

Use of a Visual Aid in addition to a Collector Bag to Evaluate Postpartum Blood loss: A Prospective Simulation Study

Brooks

Legendre

Brun

et al. 2017

Sci Rep

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Postpartum hemorrhage (PPH) is one of the most common causes of mortality in obstetrics worldwide. The accuracy of estimated blood loss is a priority in determining appropriate treatment. Will the additional use of a visual aid improve physicians’ accuracy in estimating blood loss compared to the use of a collector bag and baby scale alone? Simulation training sessions created three vaginal delivery scenarios for participants to estimate volumes of blood loss: firstly, using only a collector bag and a baby weight scale and secondly, adding a visual aid depicting known volumes of blood. The primary endpoint was to determine if participants could accurately evaluate blood loss within a 20% error margin. The addition of the visual estimator resulted in overestimation of blood loss. The rates of participants’ estimations were significantly more accurate when using the collector bag with the baby weight scale without the addition of the visual aid; 85.5% versus 33.3% (p < 0.01) for 350 mL, 88.4% versus 50.7% (p < 0.01) for 1100 mL and 88.4% versus 78.3% (p < 0.01) for 2500 mL, respectively. Additional use of a visual aid with a collector bag does not seem to be useful in improving the accuracy in the estimation of blood loss.

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“…Thompson et al (2011) reported that patients who experience PPH express interest in receiving information related to their delivery, and may benefit from counseling, psychological support, and assistance with physical recovery. Furthermore, physicians’ estimate of blood loss can often be lower than the actual volume of blood lost at delivery (Lilley et al, 2015; Toledo et al, 2007). Therefore, if blood loss is underestimated for women with PPH, then these women may develop anemia that goes undetected after delivery.…”

Section: Discussionmentioning

confidence: 99%

Knowledge of blood loss at delivery among postpartum patients

Farber

Miller

Ramachandran

et al. 2016

PeerJ

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BackgroundPostpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia.MethodsWe surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant.ResultsIn our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02).ConclusionOur findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia.

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Measurement of blood loss during postpartum haemorrhage

Cited by 77 publications

References 18 publications

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

Use of a Visual Aid in addition to a Collector Bag to Evaluate Postpartum Blood loss: A Prospective Simulation Study

Knowledge of blood loss at delivery among postpartum patients

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