Effect of Implementing Quantitative Blood Loss Assessment at the Time of Delivery.
Citation: American Journal of Perinatology. 36(13):1332-1336, 2019 11.PMID: 31087316Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Blood Transfusion | *Delivery, Obstetric | *Postpartum Hemorrhage/di [Diagnosis] | Adult | Female | Hematocrit | Humans | Postpartum Hemorrhage/th [Therapy] | Retrospective Studies | ROC Curve | Standard of CareYear: 2019ISSN:- 0735-1631
- Coviello, Elizabeth Kawakita, Tetsuya:
- https://orcid.org/0000-0002-1136-7356 https://orcid.org/0000-0003-2438-1699 https://orcid.org/0000-0002-1136-7356 https://orcid.org/0000-0003-2438-1699 Coviello, Elizabeth Kawakita, Tetsuya:
- https://orcid.org/0000-0002-1136-7356 https://orcid.org/0000-0003-2438-1699 https://orcid.org/0000-0002-1136-7356 https://orcid.org/0000-0003-2438-1699
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 31087316 | Available | 31087316 |
CONCLUSION: The rates of PPH increased with the implementation of qBL. Overall, qBL did not perform better than EBL in predicting the need for blood transfusion.
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OBJECTIVE: To evaluate the ability of estimated blood loss (EBL) and quantitative blood loss (qBL) to predict need for blood transfusion in women with postpartum hemorrhage (PPH).
RESULTS: The rate of PPH by EBL and qBL was 2.8 and 10.8%, respectively (p < 0.01). The rate of transfusion for women meeting criteria for PPH by EBL and QBL were 2% (66/3,307) and 2.7% (93/3,453), respectively (p = 0.06). Postpartum transfusion was predicted by an EBL of 1,450 mL with AUC 0.826 and qBL 1,519 mL with AUC 0.764, for all modes of delivery. Postpartum vital signs and change in pre- and postdelivery hematocrit were poor predictors for transfusion.
STUDY DESIGN: This is a retrospective chart review that identified women with PPH (>1,000 mL for vaginal or cesarean delivery) between September 2014 and August 2015, reported by EBL (n = 92), and October 2015 and September 2016, reported by qBL (n = 374). The primary metric was the area under the receiver-operating characteristic curve for blood transfusion.
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