Farber Michaela K, Miller Claire M, Ramachandran Bharathi, Hegde Priya, Akbar Kulsum, Goodnough Lawrence Tim, Butwick Alexander J
Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School , Boston , United States.
Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
PeerJ. 2016 Aug 31;4:e2361. doi: 10.7717/peerj.2361. eCollection 2016.
Postpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients' knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia.
We surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant.
In our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02).
Our findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients' knowledge gaps about PPH, transfusion and postpartum anemia.
产后出血(PPH)是导致产科发病的主要原因。对于患者在分娩时失血、产后出血以及产后出血相关疾病(包括输血和贫血)的了解程度有限。
我们对100名接受阴道分娩或剖宫产的健康产后患者进行了关于失血情况的调查,以及她们是否收到过关于输血和围产期血红蛋白(Hb)检测的信息。比较了阴道分娩与剖宫产女性的回答;P<0.05被认为具有统计学意义。
在我们的队列中,49名女性接受了阴道分娩,51名女性接受了剖宫产。只有29名(29%)女性提供了她们分娩时的失血量估计。接受剖宫产的女性比接受阴道分娩的女性更有可能收到关于输血治疗的明确信息(分别为43.1%和20.4%;P = 0.04)。与接受剖宫产的女性相比,接受阴道分娩的女性更有可能收到产后Hb检测结果(49%对29.4%;P = 0.02)。
我们的研究结果表明,女性对分娩时失血量的了解不足。给予患者的血液学信息因分娩方式而异。需要进一步研究以更好地理解患者关于产后出血、输血和产后贫血知识差距的临床意义。