Compare estimation of postpartum hemorrhage using visual estimation and national guideline for vaginal delivery in postpartum period"

Document Type : Original Article


1 Lecture of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Lecture of Midwifery, School of Nursing and Midwifery, Neishabour Islamic Azad University, Neishabour, Iran

3 Assistant Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Lecture of Statistics, School of Basic Science, Hormozgan University, Bandar Abbas branch, Bandar Abbas, Iran.

5 B.Sc of Midwifery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Postpartum hemorrhage is a major cause of maternal mortality especially in developing country. To estimate the rate of postpartum hemorrhage, visual estimation is the most common method used by staff, however, numerous studies have shown that it is incorrect, but it is an easy method and requires no tools. This study was performed with the aim to compare the visual estimation (without using criteria) and visual estimation using national guideline of vaginal delivery.
Methods: This cross-sectional and descriptive study was performed on 112 women who had referred to Mashhad Omolbanin hospital for vaginal delivery in 2012-2013. After completion of the third stage of labor, the rate of bleeding was estimated by a midwife in the visual method and an interval of 1 and 2 hours after delivery. Also, at the same intervals, the rate of bleeding was estimated using a national guideline for vaginal delivery by one of the midwives working in the shift, then, a comparison between these two estimation methods was performed. Statistical analysis was performed using SPSS software and dependent t test. PResults: The estimation of postpartum hemorrhage with visual estimation and national guideline estimation was significantly different (Visual estimation 37.57 ± 12.39 cc vs. National Guideline 45.31 ± 13.48cc) that this difference in estimation of bleeding was more observed in the first hour (P=0.000).  
Conclusion: Simulation of the conditions of postpartum hemorrhage and training using national guideline of vaginal delivery can increase the accuracy of the estimation, therefore, training of personnel using this guideline is recommended.


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