The Accuracy of Blood Loss Estimation After Simulated Vaginal Delivery

Abstract

Calibrated vaginal delivery drapes improve blood loss estimation.

Serum uric acid as a novel marker for uterine atony and post-spinal vasopressor use during cesarean delivery

“…[37][38][39] No correlation was observed with elevated serum UA and blood loss, as determined by a change in hematocrit or the need for blood transfusion. This result was not surprising, given that estimations of blood loss are notably subjective and inaccurate 40,41 and uterine atony often occurs in the absence of recognized risk factors. 26 Moreover, with only 13 patients requiring blood transfusion, our study was most likely underpowered to detect differences in blood loss.…”

Measurement of blood loss during postpartum haemorrhage

“…Visual estimation is simple but has been shown consistently to underestimate blood loss by 30-50%, especially as the volume of blood loss increases. [3][4][5] It has been recommended that this practice should stop. 10 In our mannequin scenarios, both visual under-and over-estimates of blood loss occurred; anaesthetists over-estimated blood loss most.…”

“…Visual estimation is associated with 30-50% under-estimation of blood loss, especially for larger volumes. [2][3][4] This may account for discrepancies in the reported incidence of PPH. The incidence of PPH >1000 mL has been quoted at 3.9/1000 (95% CI 3.3-4.5), 5 while PPH >2500 mL has a reported incidence of 4.3/1000 (95% CI 3.8-4.8).…”

Obstetric Anesthesiologists as Perioperative Physicians: Improving Peripartum Care and Patient Safety

“…Simulated massive maternal hemorrhage reveals that clinicians underestimate blood loss on average by 38 % by visual inspection of the field [30]. In addition, the underestimation increases as blood loss increases [30]. Improved accuracy of blood loss estimation through live and web-based education training decreased this underestimation to 4 %; however, the improvement in blood estimation skills disappeared almost completely by 9 months after training [31,32].…”

“…All providers, including obstetric and anesthesia residents and attendings, as well as nurses, have been shown to underestimate blood loss by as much as 40 % during times of hemorrhage [29]. Simulated massive maternal hemorrhage reveals that clinicians underestimate blood loss on average by 38 % by visual inspection of the field [30]. In addition, the underestimation increases as blood loss increases [30].…”