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A Comparison of Blood Loss Determination After Vaginal Delivery in El Salvador: Visual Estimation Versus Direct Measurement
Current Issue
Volume 4, 2017
Issue 6 (November)
Pages: 81-87   |   Vol. 4, No. 6, November 2017   |   Follow on         
Paper in PDF Downloads: 67   Since Oct. 18, 2017 Views: 1744   Since Oct. 18, 2017
Authors
[1]
Emi Sasagawa, Department of Midwifery and Women’s Health, School of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
[2]
Lizeth Elias de Buendia, Health Research and Investigation Unit, National Women's Hospital, San Salvador, El Salvador.
[3]
Guillermo Antonio Ortiz Avendano, Obstetric Department, National Women's Hospital, San Salvador, El Salvador.
[4]
Alba Marina Diaz de Navarro, Nursing Department, National Women's Hospital, San Salvador, El Salvador.
[5]
Hector Anibal Barrera Erazo, Nursing Department, National Women's Hospital, San Salvador, El Salvador.
[6]
Dalia Xochitl Sandoval Lopez, Health Research and Investigation Unit, National Women's Hospital, San Salvador, El Salvador.
[7]
Rafael Antonio Cedillos, Scientific Research Council, The University of El Salvador, San Salvador, El Salvador.
[8]
Kiyoshi Kita, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
[9]
Chizuru Misago, Department of International and Cultural Studies, Tsuda College, Tokyo, Japan.
Abstract
Objective: This study aimed to compare the visual estimation and direct measurement methods for estimating blood loss in women following vaginal birth at a National Maternity Hospital in El Salvador. Study design: After delivery, attending physicians and nurses independently estimated the amount of postpartum blood loss by visual means and by direct measurement. Results: A total of 870 women underwent blood loss measurement. Visual estimation by physicians and nurses underestimated postpartum blood loss by 10.8% and 29.7%, respectively. When direct measurement of blood loss was regarded as the gold standard, visual estimation of blood loss by physicians had a sensitivity of 45.9% and a specificity of 91.1% for detecting postpartum hemorrhage (PPH). Visual estimation of blood loss by nurses had a sensitivity of 43.2% and a specificity of 94.4% for detecting PPH. Conclusions: In accordance with results from previous studies, healthcare providers tended to underestimate postpartum blood loss. The discrepancy between estimated and measured blood loss widened as blood loss volume increased. Given the low sensitivity of visual estimation in detecting PPH, this study revealed that more than half of PPH cases would not have been identified by visual estimation.
Keywords
Postpartum Hemorrhage, Visual Estimation, Direct Measurement, El Salvador
Reference
[1]
World Health Organization, Department of Reproductive Health and Research. (2004). Maternal mortality in 2000, Estimates developed by WHO, UNICEF, and UNFPA. Geneva: WHO.
[2]
World Health Organization. (2005). The world health report 2005, Make every mother and child count. Geneva: WHO.
[3]
Tourn, G., Collet, F., Lasnier, P., & Seffert, P. (2004). Usefulness of a collecting bag for the diagnosis of post-partum hemorrhage. Journal de gynécologie, obstétrique et biologie de la reproduction (Paris), 33, 229–234.
[4]
Chua, S., Ho. L. M., Vanaja, K., Nordstrom, L., Roy, A. C., & Arulkumaran, S. (1998). Validation of a laboratory method of measuring postpartum blood loss. Gynecologic and obstetric investigation, 46, 31–33.
[5]
Duthie, S. J., Ven, D., Yung, G. L., Guang, D. Z., Chan, S. Y., & Ma, H. K. (1991). Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 38, 119-124.
[6]
Stafford, I., Dildy, G. A., Clark, S. L., & Belfort, M. A., (2008). Visually estimated and calculated blood loss in vaginal and cesarean delivery. American Journal of Obstetrics & Gynecology, 199, 519.e1-7.
[7]
Al Kadri, H. M., Al Anazi, B. K., & Tamim, H. M., (2011). Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study. Archives of gynecology and obstetrics, 283, 1207-1213.
[8]
Patel, A., Goudar S. S., Geller, S. E., Kodkany, B. S., Edlavitch, S. A., Wagh. K., Patted, S. S., Naik, V. A., Moss, N., & Derman, R. J. (2006). Drape estimation vs. visual assessment for estimating postpartum hemorrhage, International journal of gynaecology and obstetrics. 93, 220-224.
[9]
Prasertcharoensuk, W., Swadpanich, U., Lumbiganon, P. (2000). Accuracy of the blood loss estimation in the third stage of labor. International journal of gynaecology and obstetrics. 71, 69-70.
[10]
World Health Organization. “The Prevention and management of postpartum haemorrhage”: Report of a technical working group, Geneva, 3-6 July, 1989. World Health Organization/Maternal and Child Health 90.7, Geueva, WHO, 1990.
[11]
Rath, W. H. (2011). Postpartum hemorrhage-update on problems of definitions and diagnosis. Acta obstetricia et gynecologica Scandinavica. 90, 421-428.
[12]
Schorn, M. N. (2010). Measurement of blood loss: review of the literature. Journal of Midwifery & Women's Health. 55, 20-27.
[13]
Larsson, C., Saltvedt, S., Wiklund, I., Pahlen, S., & Andolf, E. (2006). Estimation of blood loss after cesarean section and vaginal delivery has low validity with a tendency to exaggeration. Acta obstetricia et gynecologica Scandinavica. 85, 1448-1452.
[14]
Maslovitz, S., Barkai, G., Lessing, J. B., Ziv, A., & Many, A. (2008). Improved accuracy of postpartum blood loss estimation as assessed by simulation. Acta obstetricia et gynecologica Scandinavica. 87, 929-934.
[15]
Brant, H. A. (1967). Precise estimation of postpartum haemorrhage: difficulties and importance. British Medical Journal. 1, 398-400.
[16]
Carroli, G., Cuesta, C., Abalos, E., & Gulmezoglu, A. M. (2008). Epidemiology of postpartum haemorrhage: a systematic review. Best Practice & Research Clinical Obstetrics & Gynaecology. 22, 999-1012.
[17]
Montufar-Rueda, C., Rodriguez, L., Jarquin, J. D., Barboza, A., Bustillo, M. C., Marin F, Ortiz, G., & Estrada, F. (2013). Severe postpartum hemorrhage from uterine atony: a multicentric stud. Journal of Pregnancy. 2013, 525914.
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