Postpartum anemia: missed opportunities for prevention and recognition

Prabhu, Malavika; Bateman, Brian T.

doi:10.1111/trf.13927

Cited by 5 publications

(4 citation statements)

References 17 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Predelivery anaemia is a strong risk factor for postpartum anaemia 764,819 . Patients with moderate (Hb <9.5 g dl −1 ) to severe (Hb <8.5 g dl −1 ) postpartum anaemia may benefit from i.v.…”

Section: Discussionmentioning

confidence: 99%

“…813,815,817,818 Intravenous iron or erythropoietin in the treatment of postpartum anaemia Predelivery anaemia is a strong risk factor for postpartum anaemia. 764,819 Patients with moderate (Hb <9.5 g dl À1 ) to severe (Hb <8.5 g dl À1 ) postpartum anaemia may benefit from i.v. iron therapy, which elicited more rapid recovery, improved fatigue and depression symptoms compared with oral therapy.…”

Section: Evidence Summarymentioning

confidence: 99%

See 1 more Smart Citation

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

103

View full text Add to dashboard Cite

BACKGROUND Management of peri-operative bleeding is complex and involves multiple assessment tools and strategies to ensure optimal patient care with the goal of reducing morbidity and mortality. These updated guidelines from the European Society of Anaesthesiology and Intensive Care (ESAIC) aim to provide an evidence-based set of recommendations for healthcare professionals to help ensure improved clinical management. DESIGN A systematic literature search from 2015 to 2021 of several electronic databases was performed without language restrictions. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the methodological quality of the included studies and to formulate recommendations. A Delphi methodology was used to prepare a clinical practice guideline. RESULTS These searches identified 137 999 articles. All articles were assessed, and the existing 2017 guidelines were revised to incorporate new evidence. Sixteen recommendations derived from the systematic literature search, and four clinical guidances retained from previous ESAIC guidelines were formulated. Using the Delphi process on 253 sentences of guidance, strong consensus (>90% agreement) was achieved in 97% and consensus (75 to 90% agreement) in 3%. DISCUSSION Peri-operative bleeding management encompasses the patient's journey from the pre-operative state through the postoperative period. Along this journey, many features of the patient's pre-operative coagulation status, underlying comorbidities, general health and the procedures that they are undergoing need to be taken into account. Due to the many important aspects in peri-operative nontrauma bleeding management, guidance as to how best approach and treat each individual patient are key. Understanding which therapeutic approaches are most valuable at each timepoint can only enhance patient care, ensuring the best outcomes by reducing blood loss and, therefore, overall morbidity and mortality. CONCLUSION All healthcare professionals involved in the management of patients at risk for surgical bleeding should be aware of the current therapeutic options and approaches that are available to them. These guidelines aim to provide specific guidance for bleeding management in a variety of clinical situations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Evidence Summarymentioning

confidence: 99%

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

103

View full text Add to dashboard Cite

show abstract

“…The proposal to delay the measurement of Hb is due to the physiological hemodynamic adjustment that occurs during the early postpartum period. During pregnancy, blood hemodilution leads to a lower concentration of Hb; this is exacerbated by the iatrogenic hemodilution caused by IV fluids transfused during birth 22 . Pregnancy hemodilution is reversed 7–10 days after birth when Hb levels increase, counteracting peripartum blood loss.…”

Section: Discussionmentioning

confidence: 99%

The definition, screening, and treatment of postpartum anemia: A systematic review of guidelines

Viñaspre-Hernández

Gea-Caballero

Juárez‐Vela

et al. 2020

Birth

View full text Add to dashboard Cite

Background Postpartum anemia can negatively affect maternal health and interfere with early parenting. Thus, it is important to have clear, evidence‐informed recommendations on its diagnosis and treatment. Objective To compare global recommendations regarding the appropriate management of postpartum anemia and to highlight similarities and differences. Methods Systematic searches were conducted in the databases PubMed, CINAHL, LILACS, TRIP database, and Scopus, and in the websites of health institutions and scientific societies. Search terms were related to anemia and the postpartum period. Two hundred and eighty papers were identified; the full texts of 30 sets of guidelines were reviewed, with seven being included in the final analysis. Recommendations were extracted through an evaluation of the evidence on the definition, screening, and diagnosis of anemia. The quality of the guidelines was assessed using the AGREE II instrument. Results Two sets of guidelines have been elaborated by international organizations, and the rest were produced by professional associations within high‐resource countries. The discrepancies found in the guidelines are important and affect the definition of anemia, the criteria for screening asymptomatic women, or the criteria guiding treatment. The quality of the guidelines commonly scored between 4 and 6 on a scale of 0 to 7. Recommendations with poor‐quality evidence predominated over recommendations with high‐quality evidence. Conclusions This review highlights the need to reach a consensus on the definition of postpartum anemia, to agree on what constitutes a problem for maternal health, and to provide recommendations that reach greater consensus on its diagnosis and treatment.

show abstract

“…In Ethiopia, although few studies have been conducted in the last decade, almost all previous studies focused on assessing lactating women after they were discharged from the facility ( 29 – 31 ), which may delay the testing of PPA, resulting in logistical challenges and late initiation of the treatment, finally resulting in short- and long-term complications of anemia ( 15 , 32 ). Moreover, although the maternity ward is found to be a favorable place for the diagnosis of anemia, approximately 64% of women in Ethiopia received postpartum care late ( 33 ).…”

Section: Introductionmentioning

confidence: 99%

Immediate postpartum anemia and associated factors among women admitted to maternity ward at public hospitals in Harari Regional State, Eastern Ethiopia: A facility-based cross-sectional study

Abebe

Kure²,

Yadeta³

et al. 2022

Front. Glob. Womens Health

View full text Add to dashboard Cite

BackgroundAnemia in the postpartum period remains a considerable public health problem in developing countries, particularly in sub-Saharan Africa. It is the most common indirect cause of maternal morbidity and mortality. It is also a major health problem in women of reproductive age, affecting their quality of life, occupational capacity, lactation, and immunological function. Immediate postpartum anemia has a significant impact on women's quality of life, although its predictors have received little attention in Ethiopia, notably in Harari Regional State. Therefore, this study aimed to determine its magnitude and contributing factors in Eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted from June 1st to August 30th, 2021, among 484 postpartum women admitted to two public hospitals in Harari Regional State, Eastern Ethiopia. Data were collected using a pre-tested, structured interviewer-administered questionnaire. About 2 mL of blood samples were collected and analyzed using the cell-Dyne 1,800 machine. The collected data were entered into Epi-Data version 4.6 and analyzed using SPSS version 25. A multivariable logistic regression analysis was conducted to estimate the effect of independent variables on immediate postpartum anemia. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to report the presence of the association. Statistical significance was declared at a p-value of < 0.05.ResultsThe overall magnitude of immediate postpartum anemia was 28.1% [95% CI (23.7, 32.1)]. Lack of formal education [AOR: 3.92; 95% CI: (1.85, 8.33)], having antenatal care < 4 visits [AOR: 3.18; 95% CI: (1.53, 6.61)], a history of cesarean delivery [AOR: 3.40; 95% CI: (1.89, 6.10)], a history of maternal blood loss [AOR: 4.78; 95% CI: (2.22, 10.30)], pre-delivery Hgb level < 11 g/dl [AOR:5.46; 95% CI: (3.09,9.67)], and having no iron-folate supplementation [AOR:3.27; 95% CI: (1.31, 8.15)] were factors statistically associated with immediate postpartum anemia.ConclusionsIn this study, nearly one-third of mothers admitted for postpartum care developed anemia within 48 h of giving birth. Women's educational level, frequency of antenatal care, mode of delivery, a history of maternal blood loss, pre-delivery hemoglobin level, and iron-folate supplementation status were identified as immediate postpartum anemia risk factors. Therefore, promoting the benefits of adequate antenatal care and iron-folate supplementation during pregnancy is crucial to avoiding the risks of postpartum anemia.

show abstract

Postpartum anemia: missed opportunities for prevention and recognition

Cited by 5 publications

References 17 publications

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

The definition, screening, and treatment of postpartum anemia: A systematic review of guidelines

Immediate postpartum anemia and associated factors among women admitted to maternity ward at public hospitals in Harari Regional State, Eastern Ethiopia: A facility-based cross-sectional study

Contact Info

Product

Resources

About