The Recognition of Excessive blood loss At ChildbirTh (REACT) Study: a two‐phase exploratory, sequential mixed methods inquiry using focus groups, interviews and a pilot, randomised crossover study

Hancock, Angela; Weeks, Andrew; Furber, Christine; Campbell, Malcolm; Lavender, Tina

doi:10.1111/1471-0528.16735

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…Identificar en contextos clínicos la HPP es difícil debido a que constatar visualmente la cantidad de sangre perdida es inexacto; además, los valores hemodinámicos no son suficientes, pues muchos cambios a nivel fisiológico asociados con el embarazo pueden ocultar la hipovolemia, retardando con ello el manejo oportuno de la HPP 9 ; existen estudios que dan cuenta de que el reconocimiento en la pérdida de sangre más efectivo se encuentra basado en la experiencia e intuición de los profesionales más que en otros marcadores 15 .…”

Section: Resultsunclassified

Cuidados de enfermería en pacientes con hemorragia obstétrica durante el puerperio inmediato y puerperio mediato

Montes-Hinojosa,

Albornoz-Zamora,

González-Salas

et al. 2023

Vida y Salud

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Objetivo: identificar los cuidados de enfermería más adecuados para el manejo de pacientes con hemorragia obstétrica durante el puerperio inmediato y puerperio mediato. Método: Descriptivo documental. Resultados y conclusiones: En vista de ello, se identificó que el manejo más recomendado es el activo para la tercera etapa de parto y el monitoreo constante para el HPP tardío. Así, se constata que los agentes uterotónicos (oxitocina en primer lugar y misoprostol como segunda opción) son el primer enfoque, junto con masajes uterinos bimanuales. Solo en caso de no ser efectivo este enfoque, se recomiendan manejos más invasivos, como el taponamiento uterino, enfoque radiológico o quirúrgico.

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Section: Resultsunclassified

Cuidados de enfermería en pacientes con hemorragia obstétrica durante el puerperio inmediato y puerperio mediato

Montes-Hinojosa,

Albornoz-Zamora,

González-Salas

et al. 2023

Vida y Salud

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“…A second limitation of this study was the visual estimation of maternal blood loss. Maternal blood loss at birth can be underestimated when visual estimation is used 7,34 . Consequently, maternal blood loss may have been systematically underestimated, particularly given the infrequent documentation of cumulative blood loss within the initial 24 h postpartum.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the necessity to categorize IV fluids intake into two groups may have diluted our findings and increased the risk of a Type 2 error.A second limitation of this study was the visual estimation of maternal blood loss. Maternal blood loss at birth can be underestimated when visual estimation is used 7,34. Consequently, maternal blood loss may have been systematically underestimated, particularly given the infrequent documentation of cumulative blood loss within the initial 24 h postpartum.Currently, a large evidence gap exists regarding the administration of IV fluids during labor and their effects on maternal and neonatal outcomes.…”

mentioning

confidence: 99%

Association between intravenous fluids during labor and primary postpartum hemorrhage: A retrospective cohort study

Bruce,

Shepherd,

Khan

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionThere is a major research gap relating to the impact of intravenous (IV) fluids administration during labor on maternal and neonatal outcomes. It is biologically plausible that a relationship between volume of IV fluids and primary postpartum hemorrhage (PPH) exists. The primary objective of this study was to evaluate whether the administration of high‐volume IV fluids during labor (≥ 2500 mL) increases the risk of primary PPH and other adverse outcomes for women with a term, singleton pregnancy, in comparison to low‐volume IV fluids during labor (<2500 mL).Material and MethodsA retrospective cohort study was conducted at a tertiary referral hospital in Sydney, Australia between 1st September 2021 and 31st October 2022. Inclusion criteria were: women with a live singleton fetus in a cephalic presentation; planning a vaginal birth; and admitted for labor and birth care between 37 and 42 week gestation. The study factor was IV fluids during labor and the primary outcome was primary PPH ≥500 mL. Secondary outcomes included cesarean section and major perineal injury. Pregnancy, birth, and postnatal data were obtained from the hospital's electronic clinical database, electronic medical records, and paper fluid order documentation. Multivariable logistic regression and multiple imputation were used to explore the relationship between volume of IV fluids in labor and PPH.ResultsA total of 1023 participants were included of which 339 had a primary PPH (33.1%). There was no association between high‐volume IV fluids and PPH after adjusting for demographic and clinical factors (adjusted odds ratio [ORadj]1.02 95% confidence interval [95%CI] 0.72, 1.44). However, there was a positive association between high‐volume IV fluids and cesarean section (ORadj 1.99; 95%CI 1.4, 2.8).ConclusionsThe findings of this research are important to further knowledge relating to the administration of IV fluids during labor. The findings emphasize the importance of accurately documenting IV fluids administration and identifies research priorities to enable us to better understand the broader implications of IV fluids administration on pregnancy and perinatal outcomes.

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“…Maternal blood loss at birth can be underestimated when visual estimation is used. (7,33) Consequently, maternal blood loss may have been systematically underestimated, particularly given the infrequent documentation of cumulative blood loss within the initial 24 hours postpartum.…”

Section: Limitationsmentioning

confidence: 99%

Association between intravenous fluids during labour and primary postpartum haemorrhage: A retrospective cohort study

BRUCE,

SHEPHERD,

KHAN

et al. 2024

Preprint

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Objective: To evaluate whether the administration of high-volume intravenous (IV) fluids during labour (≥ 2500 mL) increases the risk of primary postpartum haemorrhage (PPH) and other adverse outcomes for women with a term, singleton pregnancy, in comparison to low-volume IV fluids during labour (<2500 mL). Design: Retrospective cohort study Setting: Tertiary referral hospital in Sydney, Australia Sample: 1023 women with a live singleton fetus in a cephalic presentation; planning a vaginal birth; and admitted for labour and birth care between 37 - 42 weeks gestation. Methods: The study factor was IV fluids during labour. Birth and postnatal data were obtained from electronic medical records and paper fluid order documentation. Multivariable logistic regression and multiple imputation were used to explore the relationship between volume of IV fluids in labour and PPH. Main outcome measures: The primary outcome was primary PPH ≥ 500mL. Secondary outcomes included caesarean section and major perineal injury. Results: 1023 participants were included of which 339 had a primary PPH (33.1%). There was no association between high-volume IV fluids and PPH after adjusting for demographic and clinical factors (Adjusted odds ratio [OR ]1.02 95% confidence interval [95%CI] 0.72, 1.44). However, there was a positive association between high-volume IV fluids and caesarean section (OR 1.99; 95%CI 1.4, 2.8). Conclusion: These findings are important to further knowledge relating to administration of IV fluids in labour and the potential impact of this common practice. It identifies future research priorities around documentation of IV fluids and their relationship with pregnancy and perinatal outcomes.

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The Recognition of Excessive blood loss At ChildbirTh (REACT) Study: a two‐phase exploratory, sequential mixed methods inquiry using focus groups, interviews and a pilot, randomised crossover study

Cited by 5 publications

References 36 publications

Cuidados de enfermería en pacientes con hemorragia obstétrica durante el puerperio inmediato y puerperio mediato

Cuidados de enfermería en pacientes con hemorragia obstétrica durante el puerperio inmediato y puerperio mediato

Association between intravenous fluids during labor and primary postpartum hemorrhage: A retrospective cohort study

Association between intravenous fluids during labour and primary postpartum haemorrhage: A retrospective cohort study

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