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

Archives of Gynecology and Obstetrics volume 298, pages 1071–1077 (2018)Cite this article

Abstract

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 < 0.001, r = 0.683). This was also true for patients with cesarean deliveries (p < 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.

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Funding

There were no funding sources required for this study.

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Affiliations

  1. Division of Obstetrics, University Hospital of Zürich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

    Maike Katja Kahr, Romana Brun, Roland Zimmermann, Denise Franke & Christian Haslinger

Authors
  1. Maike Katja Kahr
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  2. Romana Brun
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  3. Roland Zimmermann
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  4. Denise Franke
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  5. Christian Haslinger
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Contributions

MKK: data management, data analysis, manuscript writing. RB: data collection. RZ: project development. DF: data collection. CH: protocol development, data management, manuscript editing.

Corresponding author

Correspondence to Christian Haslinger.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kahr, M.K., Brun, R., Zimmermann, R. et al. Validation of a quantitative system for real-time measurement of postpartum blood loss. Arch Gynecol Obstet 298, 1071–1077 (2018). https://doi.org/10.1007/s00404-018-4896-0

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  • DOI: https://doi.org/10.1007/s00404-018-4896-0

Keywords

  • Blood loss measurement
  • Estimated blood loss
  • Measured blood loss
  • Postpartum blood loss
  • Postpartum hemorrhage
  • PPH