Bhatt Akshay, Hughes-Hogan Logan, Mitchell Takiyah, Nair Singh, Chuang Meleen, Chen Steven L, Reddy Shamantha
Department of Anesthesiology, Montefiore Medical Center of the Albert Einstein College of Medicine, Bronx, New York, USA.
Albert Einstein College of Medicine, Bronx, New York, USA.
Int J Gynaecol Obstet. 2023 Feb;160(2):670-677. doi: 10.1002/ijgo.14337. Epub 2022 Jul 27.
Our objective was to determine whether there is a numerical difference between quantitative blood loss (QBL) versus visual estimation of blood loss (EBL) during cesarean delivery (CD), and whether initiation of QBL leads to increased recognition and intervention for postpartum hemorrhage.
A retrospective review was conducted of 250 patients undergoing CD with only EBL documented and 250 patients undergoing CD with both EBL and QBL documented at Montefiore Medical Center between October 2017 and November 2018. Since May 2018, the protocol for all CD included documentation of EBL and QBL.
Average EBL when documented alone (897.0 ml ± 301.0 ml) trended lower than average EBL when documented with QBL (940.0 ml ± 371.0 ml, P = 0.161). For CD with both blood loss documented, average EBL (940.0 ml ± 371.0 ml) was significantly lower than average QBL (1065.3 ml ± 649.8 ml, P = 0.0001). CD with both blood loss documented had a greater number of blood transfusions (24 CD, 9.6%) versus only EBL documented (14 CD, 5.6%) (P = 0.125).
The use of QBL may function in the algorithm to determine up-front resuscitative intervention to improve maternal outcomes and merits further study.
我们的目的是确定剖宫产术中定量失血（QBL）与目测失血量（EBL）之间是否存在数值差异，以及采用QBL是否会提高对产后出血的识别和干预。
对2017年10月至2018年11月在蒙特菲奥里医疗中心进行剖宫产的250例仅记录了EBL的患者和250例同时记录了EBL和QBL的患者进行回顾性研究。自2018年5月以来，所有剖宫产的方案都包括记录EBL和QBL。
单独记录时的平均EBL（897.0 ml±301.0 ml）比与QBL同时记录时的平均EBL（940.0 ml±371.0 ml，P = 0.161）略低。对于同时记录了两种失血量的剖宫产，平均EBL（940.0 ml±371.0 ml）显著低于平均QBL（1065.3 ml±649.8 ml，P = 0.0001）。同时记录了两种失血量的剖宫产输血的患者数量更多（24例，9.6%），而仅记录了EBL的剖宫产输血患者数量为（14例，5.6%）（P = 0.125）。
使用QBL可能有助于在算法中确定预先的复苏干预措施，以改善产妇结局，值得进一步研究。
