Influence of pregnancy on one-compartmental bio-metric blood loss calculations after cesarean section and gynaecological surgery

Abstract

To date there are no data in the literature on the procedure for the indirect measurement of blood loss during cesarean section, based on the post-operative drop in haemoglobin (Hb), which has been due to the lack of biometrically determined parameters for the calculation of blood volume in pregnant women. This study was therefore conducted to determine the applicability of the drop in Hb levels blood loss calculation during cesarean section, based on a model previously validated in non-pregnant women. We compared this procedure in 54 patients who underwent cesarean section and 12 non-pregnant patients subjected to gynaecological surgery. The coefficient of the regression slope for the blood volume collected during surgery and the calculated blood loss in pregnant (y=0.6286x+366) and non-pregnant patients (y=0.7605x+514) did not show any significant difference (t=1.1009, p>0.5, 95% confidence interval:-2.736, +2.473). Our study therefore demonstrated the applicability of the procedure for the indirect measurement of surgical blood loss both in pregnant and non-pregnant women.

One-compartmental biometric blood loss calculation after cesarean section

“…0.184x, r = 0.599, SD = 0.059, p \ 0.0001). Popovic and Grujic (2008) found no significant difference between collected and calculated blood loss (using equation of Flordal) in 12 non-pregnant gynecological patients neither significant linear correlation (r = 0.155, p [ 0.5). In this case, small analyzed population (n = 12) could be reason for the absence of linear correlation between collected and calculated blood loss.…”

Application of one-compartmental bio-metric blood loss calculations with transfused blood volume taken into account after aneurysmectomy

“…Computer simulations have shown that physiological fluid volume received during operation could affect the blood loss calculations, but this occurred to be of minor importance (Bayer et al 2000;Lagneau et al 2005;Popovic and Grujic 2008). More important, as previously said, the patients received blood transfusion during operation and the received blood volume was considered when calculated blood loss was correlated with collected blood loss.…”

“…The swabs may also have absorbed irrigation fluids, exudates or, in the case of cesarean section, and amniotic fluid (Popovic and Grujic 2008). Swabs can be washed to extract blood but this is a complicated procedure.…”

“…The drainage of blood from the operative site may be incomplete because the blood may remain in the operative area, clotting may occur in the drainage tubes or large volumes may remain in the operative site with no external evidence of this being the case. The type of the treatment, for example, when hemostatic drug are being investigated, may influence on the function of the drainage system (Flordal 1997;Popovic and Grujic 2008).…”

Safety of uneventful cesarean section in terms of hemorrhage

“…Hemorrhage was defined as decrease in Hb/ Htc levels of 30% and 10% or greater, respectively, or calculated blood loss greater than 1500 ml, or any need of packed red cell transfusion [4]. Estimated blood loss was calculated according to a model which was found to be useful in indirect measurement of blood loss by Popovic et al in obstetric patient population [5]. Women with any risk factors associated with increased risk of postpartum hemorrhage, such as excessive uterine distension, antepartum hemorrhage, abnormal hemostasis profile, systemic diseases, anemia (Hb <8 g), pregnancy specific diseases, history of a prior postpartum hemorrhage, obesity (BMI >30) were all excluded from the study.…”