Visually estimated and calculated blood loss in vaginal and cesarean delivery

Stafford, Irene; Dildy, Gary A.; Clark, Steven L.; Belfort, Michael A.

doi:10.1016/j.ajog.2008.04.049

Cited by 294 publications

(249 citation statements)

References 16 publications

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“…Intraoperative findings, including a difficulty in placental separation, degree of placental invasion, bleeding from the placental site, amount of blood loss, intraoperative blood transfusion, need for internal iliac ligation or emergency hysterectomy to control the bleeding, and histopathology results of the removed uteri in cases managed by emergency hysterectomy specialists were recorded (21). The calculated estimated blood loss (cEBL) was evaluated using the formula proposed by Stafford et al (22). Intraoperative findings ( Figure 5) were compared with preoperative sonography findings to detect the accuracy of the 3D MSV Doppler to diagnose MAP.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

Moniem¹,

Ibrahim²,

Akl³

et al. 2015

J Turkish German Gynecol Assoc

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Placenta accreta occurs when placental trophoblasts invade the endometrium beyond the Nitabuch's layer of decidua basalis, placenta increta occurs when placental trophoblasts invade the myometrium, and placenta percreta occurs when placental trophoblasts invade the serosa (1, 2). Morbid adherent placenta (MAP) is generally associated with excess blood loss, bladder injuries and hysterectomies (3, 4). The incidence of MAP has increased significantly over the last 50 years (5, 6). A past history of a cesarean delivery, placenta previa, and damage of the Nitabuch's layer of decidua basalis following intrauterine infection or scarring are the risk factors of MAP. The incidence of MAP is increased concomitantly with increased cesarean section rates (1, 7-9). The incidence of MAP is 3.3% in pregnant women with no past history of cesarean delivery and placenta previa and is 40% in pregnant women with a history of two cesarean sections and placenta previa (4). If MAP was diagnosed or suspected before delivery, the optimum time for planned delivery is around 34-35 weeks, following a course of corticosteroids and multidisciplinary team care approach (2, 10, 11). An accurate diagnosis of MAP is essential to prepare both the patient and health providers for possible complications during delivery. Authors reported that ultrasound is a useful tool to diagnose MAP, with 77%-93% sensitivity and 71%-98% specificity (12-16). Moodley et al. (17) concluded that the color flow Doppler was more specific, with a 95% negative predictive value (NPV) in the prenatal diagnosis of MAP, than magnetic resonance imaging (MRI), and MRI should be reserved for cases with inconclusive sonographic findings (13,15,17). The sonographic markers of placenta accreta can be seen in the first trimester of pregnancy in the form of low implantation of the pregnancy sac and multiple vascular spaces within the placenta (2). Prenatal diagnosis of MAP with gray-scale and Doppler sonography allows the development of the multidisciplinary team care approach during delivery (14). This current study aimed Objective: To detect the accuracy of the three-dimensional multislice view (3D MSV) Doppler in the diagnosis of morbid adherent placenta (MAP). Material and Methods:Fifty pregnant women at ≥28 weeks gestation with suspected MAP were included in this prospective study. Two dimensional (2D) trans-abdominal gray-scale ultrasound scan was performed for the subjects to confirm the gestational age, placental location, and findings suggestive of MAP, followed by the 3D power Doppler and then the 3D MSV Doppler to confirm the diagnosis of MAP. Intraoperative findings and histopathology results of removed uteri in cases managed by emergency hysterectomy were compared with preoperative sonographic findings to detect the accuracy of the 3D MSV Doppler in the diagnosis of MAP. Results:The 3D MSV Doppler increased the accuracy and predictive values of the diagnostic criteria of MAP compared with the 3D power Doppler. The sensitivity and negative predictive value (NPV) (79.6%...

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Section: Methodsmentioning

confidence: 99%

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

Moniem¹,

Ibrahim²,

Akl³

et al. 2015

J Turkish German Gynecol Assoc

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“…Geleneksel olarak PPK, vajinal doğum sonrası ≥500 ml, sezaryen ile doğum sonrası ≥1000 ml kanamanın olması şeklinde tanım-lanırken, mevcut kanamanın klinisyen tarafından olduğundan daha az tahmin edilmesi ve gözle görüle-meyen kanamanın varlığı bu tanımlamanın klinikte kullanımını zorlaştırmaktadır (6,7) . Önerilen diğer tanım ise hematokritte yüzde 10 azalmanın olmasıdır.…”

Section: Tanımunclassified

The prevention and management of postpartum hemorrhage

Kaya¹,

Sezer²

2017

IKSST

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“…Underestimation of blood loss at delivery time is one the reasons of the delayed diagnosis of blood loss. Many studies indicate that assessment of post-partum blood loss following a vaginal delivery is difficult and visual estimation of blood loss is frequently inaccurate [11][12][13] . Another method for measuring postpartum blood loss is calculated of Ht and Hb variations before and after…”

Section: Introductionmentioning

confidence: 99%

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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Visually estimated and calculated blood loss in vaginal and cesarean delivery

Cited by 294 publications

References 16 publications

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

The prevention and management of postpartum hemorrhage

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

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