Validation of a quantitative system for real-time measurement of postpartum blood loss

Purpose Reliable real-time estimation of blood loss is crucial for the prompt management of postpartum hemorrhage (PPH), which is one of the major obstetric complications worldwide. Our study aims at the validation of feasibility and precision of measured blood loss (MBL) with a quantitative real-ti...

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Published in:Archives of gynecology and obstetrics 2018-12, Vol.298 (6), p.1071-1077
Main Authors: Kahr, Maike Katja, Brun, Romana, Zimmermann, Roland, Franke, Denise, Haslinger, Christian
Format: Article
Language:English
Subjects:
Childbirth & labor
Endocrinology
Gynecology
Health risk assessment
Hemoglobin
Human Genetics
Maternal-Fetal Medicine
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
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container_end_page 1077
container_issue 6
container_start_page 1071
container_title Archives of gynecology and obstetrics
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creator Kahr, Maike Katja
Brun, Romana
Zimmermann, Roland
Franke, Denise
Haslinger, Christian
description Purpose Reliable real-time estimation of blood loss is crucial for the prompt management of postpartum hemorrhage (PPH), which is one of the major obstetric complications worldwide. Our study aims at the validation of feasibility and precision of measured blood loss (MBL) with a quantitative real-time measurement system during (1) vaginal delivery and (2) cesarean section by comparison with a hemoglobin-based formula for blood loss as an objective control. This is the first study to include a reasonable number of patients in an everyday clinical setting. Methods 921 patients were prospectively enrolled into this study (vaginal delivery: n  = 461, cesarean delivery: n  = 460) at a tertiary care hospital in Switzerland. Blood loss was measured by quantitative fluid collection bags. “Calculated blood loss” (CBL) was determined by modified Brecher`s formula based on the drop of hemoglobin after delivery. MBL based on our measurement system was compared to CBL by correlation analysis and stratified by the mode of delivery. Results During vaginal delivery, MBL as determined by our quantitative measurement system highly correlated with CBL ( p 
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Our study aims at the validation of feasibility and precision of measured blood loss (MBL) with a quantitative real-time measurement system during (1) vaginal delivery and (2) cesarean section by comparison with a hemoglobin-based formula for blood loss as an objective control. This is the first study to include a reasonable number of patients in an everyday clinical setting. Methods 921 patients were prospectively enrolled into this study (vaginal delivery: n  = 461, cesarean delivery: n  = 460) at a tertiary care hospital in Switzerland. Blood loss was measured by quantitative fluid collection bags. “Calculated blood loss” (CBL) was determined by modified Brecher`s formula based on the drop of hemoglobin after delivery. MBL based on our measurement system was compared to CBL by correlation analysis and stratified by the mode of delivery. Results During vaginal delivery, MBL as determined by our quantitative measurement system highly correlated with CBL ( p  &lt; 0.001, r  = 0.683). This was also true for patients with cesarean deliveries ( p  &lt; 0.001, r  = 0.402), however, in a less linear amount. In women with cesarean deliveries, objectively low blood loss tended to be rather overestimated, while objectively high blood loss was more likely underestimated. Conclusions The technique of real-time measurement of postpartum blood loss after vaginal delivery as presented in this study is practicable, reliable and strongly correlated with the actual blood loss and, therefore, poses an actual improvement in the management of PPH.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-018-4896-0</identifier><identifier>PMID: 30225686</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Childbirth &amp; labor ; Endocrinology ; Gynecology ; Health risk assessment ; Hemoglobin ; Human Genetics ; Maternal-Fetal Medicine ; Medicine ; Medicine &amp; Public Health ; Obstetrics/Perinatology/Midwifery</subject><ispartof>Archives of gynecology and obstetrics, 2018-12, Vol.298 (6), p.1071-1077</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Archives of Gynecology and Obstetrics is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-8bbf2fc8516564997e2d1da233d7ee3ca98a6a01c4db4625ffadd67079daa38a3</citedby><cites>FETCH-LOGICAL-c372t-8bbf2fc8516564997e2d1da233d7ee3ca98a6a01c4db4625ffadd67079daa38a3</cites><orcidid>0000-0003-3344-9480</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30225686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kahr, Maike Katja</creatorcontrib><creatorcontrib>Brun, Romana</creatorcontrib><creatorcontrib>Zimmermann, Roland</creatorcontrib><creatorcontrib>Franke, Denise</creatorcontrib><creatorcontrib>Haslinger, Christian</creatorcontrib><title>Validation of a quantitative system for real-time measurement of postpartum blood loss</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose Reliable real-time estimation of blood loss is crucial for the prompt management of postpartum hemorrhage (PPH), which is one of the major obstetric complications worldwide. Our study aims at the validation of feasibility and precision of measured blood loss (MBL) with a quantitative real-time measurement system during (1) vaginal delivery and (2) cesarean section by comparison with a hemoglobin-based formula for blood loss as an objective control. This is the first study to include a reasonable number of patients in an everyday clinical setting. Methods 921 patients were prospectively enrolled into this study (vaginal delivery: n  = 461, cesarean delivery: n  = 460) at a tertiary care hospital in Switzerland. Blood loss was measured by quantitative fluid collection bags. “Calculated blood loss” (CBL) was determined by modified Brecher`s formula based on the drop of hemoglobin after delivery. MBL based on our measurement system was compared to CBL by correlation analysis and stratified by the mode of delivery. Results During vaginal delivery, MBL as determined by our quantitative measurement system highly correlated with CBL ( p  &lt; 0.001, r  = 0.683). This was also true for patients with cesarean deliveries ( p  &lt; 0.001, r  = 0.402), however, in a less linear amount. In women with cesarean deliveries, objectively low blood loss tended to be rather overestimated, while objectively high blood loss was more likely underestimated. 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This was also true for patients with cesarean deliveries ( p  &lt; 0.001, r  = 0.402), however, in a less linear amount. In women with cesarean deliveries, objectively low blood loss tended to be rather overestimated, while objectively high blood loss was more likely underestimated. Conclusions The technique of real-time measurement of postpartum blood loss after vaginal delivery as presented in this study is practicable, reliable and strongly correlated with the actual blood loss and, therefore, poses an actual improvement in the management of PPH.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30225686</pmid><doi>10.1007/s00404-018-4896-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3344-9480</orcidid></addata></record>
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subjects Childbirth & labor
Endocrinology
Gynecology
Health risk assessment
Hemoglobin
Human Genetics
Maternal-Fetal Medicine
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
title Validation of a quantitative system for real-time measurement of postpartum blood loss
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