What is the normal range of obstetric shock index in the immediate postpartum period in a low‐resource setting?

Nwafor, Johnbosco Ifunanya; Nobert, Chuka; Onuorah, Olisah Elvis; Onwe, Blessing Idzuinya; Ibo, Chukwunenye Chukwu; Onuchukwu, Victor Uchenna

doi:10.1002/ijgo.13297

Cited by 5 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study of a general population of women with vaginal childbirth, we found a distribution of SI values early postpartum similar to those found in previous analyses of postpartum SI values conducted on selected populations of women without PPH. [13][14][15][16] The SI values we report were also close to those reported during pregnancy 40 and higher than those reported in young adults. 5,6 Regarding the performance of SI for predicting PPH, comparing our results with the literature is challenging, as the previous studies used populations, outcomes, SI measurement times and methods that were different from ours.…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

“…In obstetrics, a few cohort studies, restricted to women without PPH, have described the SI range in the immediate postpartum period, reporting a 0.5-0.9 range with a median around 0.7. [13][14][15][16][17] The distribution of SI in the immediate postpartum period in an unselected population of women giving birth is thus unknown.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Shock index as a predictor of postpartum haemorrhage after vaginal delivery: Secondary analysis of a multicentre randomised controlled trial

Madar

Deneux‐Tharaux

Sentilhes

2023

BJOG

View full text Add to dashboard Cite

ObjectiveTo describe the shock index (SI) distribution during the first 2 hours after delivery and to evaluate its performance when measured 15 and 30 minutes after delivery for predicting postpartum haemorrhage (PPH) occurrence in the general population of parturients after vaginal delivery.DesignSecondary analysis of a multicentre randomised controlled trial testing prophylactic administration of tranexamic acid versus placebo in addition to prophylactic oxytocin to prevent PPH.Setting15 French maternity units in 2015–2016.Sample3891 women with a singleton live fetus ≥35 weeks, born vaginally.MethodsFor each PPH‐related predicted outcome, we calculated the area under the receiver operating characteristic curve (AUROC) values of the SI at 15 and 30 minutes after delivery and its predictive performance for SI cut‐off values of 0.7, 0.9 and 1.1.Main outcome measuresQuantitative blood loss ≥1000 ml (QBL ≥1000 ml) measured in a graduated collector bag and provider‐assessed clinically significant PPH (cPPH).ResultsPrevalence of QBL ≥1000 ml and cPPH was respectively 2.7% (104/3839) and 9.1% (354/3891). The distributions of the SI at 15 and 30 minutes after delivery were similar with a median value of 0.73 and 97th percentile of 1.11 for both. The AUROC values of the 15‐minute SI for discriminating QBL ≥1000 ml and cPPH were respectively 0.66 (lower limit of the 95% confidence interval [LCI] 0.60) and 0.56 (LCI 0.52); and for the 30‐minute SI 0.68 (LCI 0.61) and 0.49 (LCI 0.43).ConclusionsThe shock index at 15 and 30 minutes after delivery did not satisfactorily predict either QBL ≥1000 ml or clinical PPH.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

See 1 more Smart Citation

Shock index as a predictor of postpartum haemorrhage after vaginal delivery: Secondary analysis of a multicentre randomised controlled trial

Madar

Deneux‐Tharaux

Sentilhes

2023

BJOG

View full text Add to dashboard Cite

show abstract

“…The possible reason for the similarities might be the systolic blood pressures obtained are higher than the heart rates. The finding of this study regarding the shock index range after childbirth is similar to the findings of the study conducted by Nwafor et al (2020) on what is the normal range of obstetric shock index in the immediate postpartum period in a low resource setting, in Abakiliki, Nigeria. The possible reasons for the similarities recorded in both studies might be owing to the conduct of the studies in the same geographic location and low resource settings.…”

Section: Discussionsupporting

confidence: 86%

Sonographic evaluation of maternal blood loss after childbirth using postpartum inferior vena cava diameter among parturients in Kano Metropolis, Nigeria

Saleh,

Ohagwu,

Okonkwo

et al. 2023

dujopas

View full text Add to dashboard Cite

Postpartum hemorrhage has been a major cause of maternal morbidity and mortality globally every year. Sonographic measurement of inferior vena cava diameter is a cheap, safe, non-invasive method and an indicator of blood loss after childbirth. The study was aimed to establish normal range values of postpartum inferior vena cava (IVC) among parturients in Kano metropolis, Nigeria. A prospective and longitudinal study from September, 2021 to September, 2022 was adopted and a minimum sample size of 210 measurements of IVC intraluminal diameter was calculated for the study using G Power sample size software. The sample comprised of two sets measurements obtained from 105 parturients before delivery and after delivery. The maternal heart rate and systolic blood pressure were measured. Blood samples from all subjects were collected. The data was analyzed using IBM Statistical Software. The range value of IVC diameter on inspiration of the subjects before childbirth was 13.2 mm – 20.3 mm, after childbirth was 9.1 mm – 16.7 mm. The IVC diameter range on expiration before childbirth was 17.3 mm – 24.8 mm, after childbirth was 12.6 mm – 21.4 mm. The Packed Cell Volume (PCV) range of the subjects before childbirth was 35% – 40%, after childbirth was 18% – 33%. The heart rate before childbirth was 64 bpm – 100 bpm, after childbirth was 70 bpm – 100 bpm. The systolic blood pressure before childbirth was 110 mmHg – 120 mmHg, after childbirth was 90 mmHg – 120 mmHg. The shock index before childbirth was 0.5 – 0.9 and after childbirth was 0.6 – 0.9. A statistical significant (p<0.001) difference in IVC was observed. Furthermore, a statistical significant (p<0.001) difference was obtained in PCV, maternal heart rate, systolic blood pressure and shock index. There was a statistical significant strong positive correlation between IVC and PCV during inspiration and expiration before and after childbirth.

show abstract

“…В на-шем пилотном исследовании оценка родильниц с ПРК в зависимости от кровопотери в процентах от ОЦК продемонстрировала, что ОК в группе с ПРК был > 500 мл и составил 880 (697-1171) мл, что согласуется с общепринятыми методами диагностики кровопотери. Однако мы не выявили ни у одной из этих пациенток нарушения гемодинамики или увеличения ШИ выше 0,9, который является верхней границей нормы показателей ШИ у беременных в доношенном сроке [20][21][22].…”

Section: Discussionunclassified

Assessment of volemic status in postpartum period: a pilot prospective cohort study

Ronenson

Shifman

Kulikov

2021

Annals of Critical Care

View full text Add to dashboard Cite

Introduction. The concept of permissible blood loss during childbirth and during caesarean section (CS) remains a subject of discussion. Also, a controversial issue is the adequacy of the assessment of the volume of blood loss in women in labor based on body weight. Criteria for the appointment of infusion therapy for postpartum hemorrhage (PPH) I-II stage are controversial and require research in this area. Objectives. Determination of the optimal method for assessing blood volume loss to identify women with PPH. Materials and methods. In a pilot prospective cohort study, 30 pregnant, prepared for planned CS. The primary endpoints of the study were the assessment of the volume of blood loss depending on the method of determination, the assessment of TTE and ultrasound of the inferior vena cava in postpartum period after elective CS. Results. Assessment of the volume of blood loss as a percentage of the circulating blood volume revealed 30 % of women with PPH who were not diagnosed by visual assessment, and 16 % of women with PPH who were not diagnosed by gravimetric assessment of the volume of blood loss. Postpartum hemorrhage I-II gr. does not always require replacement fluid therapy. Statistically significant large indices of the collapse index of the inferior vena cava and central hemodynamics indicated a hyperdynamic response of the circulatory system in postpartum women with postpartum hemorrhage due to the redistribution of the water sector. Conclusions. The calculation of the blood volume by the patient’s weight during pregnancy leads to an underestimation of the frequency of PPH of I-II severity in almost every 6 women. The data obtained cast doubt on the existing classification of postpartum hemorrhage depending on the amount of blood loss and require further research in this area to determine the optimal methods for diagnosing the severity of PPH.

show abstract

What is the normal range of obstetric shock index in the immediate postpartum period in a low‐resource setting?

Cited by 5 publications

References 13 publications

Shock index as a predictor of postpartum haemorrhage after vaginal delivery: Secondary analysis of a multicentre randomised controlled trial

Shock index as a predictor of postpartum haemorrhage after vaginal delivery: Secondary analysis of a multicentre randomised controlled trial

Sonographic evaluation of maternal blood loss after childbirth using postpartum inferior vena cava diameter among parturients in Kano Metropolis, Nigeria

Assessment of volemic status in postpartum period: a pilot prospective cohort study

Contact Info

Product

Resources

About