Postpartum Hemorrhage (PPH) is the leading cause of maternal deaths worldwide. Visual estimation of blood loss (EBL) can result in underestimation of blood loss, causing delay and failure of early interventions for PPH, thus adversely affecting maternal morbidity and mortality. The California Maternal Quality Care Collaborative (CMQCC) hemorrhage toolkit suggests Quantitative Blood Loss (QBL) is a more accurate measure. The purpose of this study is to determine if QBL is a more accurate measure of blood loss than EBL at Community Regional Medical Center (CRMC) in order to standardize PPH management.METHODS:
A retrospective cross sectional study was performed at CRMC on postpartum patients from February to June 2016. The variables investigated were pre- and post-delivery hemoglobin, EBL and QBL. The blood loss calculated from the difference between pre- and post-delivery hemoglobin levels was compared to the blood loss given by QBL and EBL.RESULTS:
A total of 303 cases were reviewed. The mean QBL was 310.57mL and the mean EBL was 255.39mL. The difference was statistically significant (p=0.036). The Pearson correlation coefficient between change in hemoglobin and QBL was 0.28. For EBL, the correlation was 0.25. Both correlation coefficients were statistically significant (p<0.05).CONCLUSION:
In our study, QBL appears to be a more accurate measure of blood loss than EBL. Additional data from deliveries at CRMC in 2017 are being reviewed given that the process of QBL has continued to improve with better education, compliance and changes in available resources. We hope to find a stronger correlation between QBL and blood loss.