Knowledge of blood loss at delivery among postpartum patients

Abstract

BackgroundPostpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients’ knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia.MethodsWe surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant.ResultsIn our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02).ConclusionOur findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients’ knowledge gaps about PPH, transfusion and postpartum anemia.

The Usefulness of Zhukovsky Double Balloon in Obstetric Hemorrhage

“…1,2 It is known that only 62%-65% of vaginal births are accompanied by physiological blood loss (within 500 mL of blood), 3 one third of patients have blood loss of 500-1000 mL, and in 3%-8% of cases the volume of blood loss exceeds 1.5% of the maternal weight, and this is considered a massive loss, requiring transfusions and often removal of the uterus. 4 The risk factors of obstetric hemorrhage are multifaceted 5,6 : age of primiparous women (older than 35 years), parity (more than six previous deliveries), a high number of previous caesarean sections, a short time interval from the previous abdominal delivery, and multiple pregnancy. 7,8 Some authors consider anomalies of placentation, the placenta accreta spectrum disorders, and placental abruption [9][10][11][12] as the leading causes of the development of massive obstetric bleeding, while others report atony of the uterus as the main cause.…”