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

Document Type : Original Article

Authors

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.

Abstract

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.

Keywords

References

  1. Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA, et al. Pregnancy-related mortality surveillance—United States, 1991–1999. MMWR Surveill Summ 2003; 52: 1–8.
  2. Kuhn KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PFA. WHOanalysis of causes of maternal death: A systematic review. Lancet 2006; 367: 1066–74.
  3. Gary A., Dildy III M.D. Postparum Hemorrhage: New management options. Clin Obstet Gynecol.2002; 45(2): 330 – 344.
  4. Bowes WA Jr, Thorp JM. Clinical aspects of normal and abnormal labor. In: Creasy RK, Resnik R, editors. Maternal-fetal medicine, 5th ed. Philadelphia: Saunders, 2004: 678–9.
  5. Mander R, Smith GD. Saving Mothers' Live (Formerly Why Mothers Die): Reviewing Maternal Deaths To Make Motherhood Safer 2003- 2005. Midwifery 2008; 24: 8- 12.
  6. Berg CJ, Harper MA, Atkinson SM, Bell EA, Brown HL, Hage ML, et al. Preventability of Pregnancy Related Deaths: Results of A State-Wide Review. Obstetrics & Gynecology 2005;106:1228-1235.
  7. Dildy III GA, Paine AR, George NC, Velasco C. Estimating Blood Loss: Can Teaching Significantly Improve Visual Estimation? Obstetrics & Gynecology 2004; 104: 601-607.
  8. Patel A, Goudar SS, Geller SE, Kodkany BS, Edlavitch SA, Wagh K, et al. Drape estimation vs. visual assessment for estimating postpartum hemorrhage. Int J Gynaecol Obstet 2006; 93(3):220-4.
  9. Prasertcharoensuk W, Swadpanich U, Lumbiganon P. Accuracy of the blood loss estimation in the third stage of labor. Int J Gynecol Obstet. 2000; 71: 69–70.
  10. Glover P. Blood loss at delivery: how accurate is your estimation? Aust J Midwifery. 2003; 16: 21–4. [PubMed]
  11. Razvi K, Chua S, Arulkumaran S, Ratnam SS. A comparison between visual estimation and laboratory determination of blood loss during the third stage of labour. Aust NZ J Obstet Gynaecol. 1996; 36: 152–4.
  12. Carroli G, Cuesta C, Abalos E, Gulmezoglu AM. Epidemiology of postpartum hemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2008; 22: 999–1012. [PubMed]
  13. Sukprasert M, Choktanasiri W, Ayudhya NI, Promsonthi P, O-Prasertsawat P. Increase accuracy of visual estimation of blood loss from education programme. J Med Assoc Thai 2006; 89:S54–9.
  14. Moscati R, Billittier AJ, Marshall B, Fincher M, Jehle D, Braen R. Blood loss estimation by out-of-hospital emergency care providers. Prehosp Emerg Care 1999; 3: 239–42.
  15. Maslovitz S, Barkai G, Lessing JB, Ziv A, Many A. Improved accuaracy of postpartum blood loss estimation as assessed by simulation. Acta Obstet Gynecol 2008; 87: 929–34.

Files

Share

How to cite

Statistics