A comparison of changes in maternal haemoglobin concentration following instrumental and normal delivery

Abstract

The occurrence of primary postpartum haemorrhage and its relation to changes in maternal haemoglobin concentration following instrumental delivery were studied in 337 consecutive operative vaginal deliveries. The postpartum haemorrhage rate in the instrumental delivery group was 24.3 per cent compared with 4.4 per cent for a control group of spontaneous vertex deliveries. Following instrumental delivery 26 per cent had an excessive reduction in haemoglobin concentration. Estimated blood of blood loss at delivery correlated poorly with reduction in haemoglobin concentration, but in 7.4 per cent of the study group the postnatal haemoglobin concentration was less than 8 g/dl, compared with 0.9 per cent in the control group. Blood transfusions were given more frequently in the instrumental vaginal delivery group ( I 1.3 per cent) compared with the control group (1.4 per cent) and also when compared with women delivered by caesarean section (7 per cent). Improvement in securing haeniostasis promptly after instrumental delivery is needed if the incidence of excessive blood loss and subsequent blood transfusion is to be reduced. Downloaded by [University of Otago] at 17:08 18 July 2015 Quinn: Changes in maternal haemoglobin concentration following delivery 347 Gilbert L., Porter W. and Brown V. A. (1987) Postpartum haemorrhage-a continuing problem. British Journal of Obstetrics and Gynaecology 94, 67-7 1. Moir D. D. and Wallace G . (1967) Blood loss at forceps delivery. Journal of Obstetrics and Gynaecology of British Commonwealth 74, 424429. Prendiville W., Elbourne D. and Chalmers I. (1988) The effect of routine oxytocic administration in the management of the third stage of labour: an overview of the evidence from controlled trials. British Journal of Obsteirics and Gynaecology 95, 3-16. (1992) Neonatal and maternal morbidity in relation to the length of the second stage of labour.