Comparison of four methods of blood loss estimation after cesarean delivery

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• 作者：Manoj Withanathantrige^a ; Malik Goonewardene^a ; ^b ; ^{malikg@eureka.lk" class="auth_mail" title="E-mail the corresponding author} ; Ranmalie Dandeniya^b ; Pabashani Gunatilake^b ; Sasini Gamage^b
• 关键词：Agreement between methods ; Cesarean delivery ; Estimated blood loss ; Postpartum hemorrhage
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：135
• 期：1
• 页码：51-55
• 全文大小：334 K

文摘

To assess agreement between four different methods of blood loss estimation after lower-segment cesarean delivery (LSCD).

Methods

A secondary analysis was undertaken of a randomized controlled trial of three timings of cord clamping during LSCD performed at a center in Sri Lanka between January 21 and April 30, 2013. Eligible women underwent prepartum LSCD at 37–39 weeks of pregnancy. Estimated blood loss (EBL) was assessed by a combined method (direct measurements of spilled blood and sucker bottle volumes, and weighing of surgical towels and drapes before and after use), according to visual assessments by the surgeon and by anesthesiologists, and by measurement of preoperative and postoperative hemoglobin levels.

Results

Among 156 participants, mean EBL was 502 mL (95% CI 370–618) from the combined method, 506 mL (412–643) calculated from hemoglobin levels, 484 mL (367–621) by the surgeon’s estimation, and 491 mL (361–612) by anesthesiologists’ estimation (P = 0.32). Visual assessment of EBL by anesthesiologists had the best intraclass correlation (0.713) and limits of agreement with the combined method. There were no significant differences between the proportion of cases in which anesthesiologists and the surgeon underestimated or overestimated the EBL when compared with the combined method.

Conclusion

EBL should be ideally obtained by the combined method.