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Introduction of standardized, cumulative quantitative measurement of blood loss into routine maternity care

Powell, E., James, D., Collis, R., Collins, P.W. ORCID:, Pallmann, P. ORCID: and Bell, S. 2022. Introduction of standardized, cumulative quantitative measurement of blood loss into routine maternity care. Journal of Maternal-Fetal and Neonatal Medicine 35 (8) , pp. 1491-1497. 10.1080/14767058.2020.1759534

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ntroduction: Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity in the UK. Visual estimation of blood loss is unreliable yet remains common practice. As part of a national quality improvement project to improve care during PPH, standardized, quantitative measurement of blood loss (QBL) for all deliveries was introduced into a tertiary obstetric unit in Cardiff, Wales. Methods: Retrospective analysis of 875 consecutive maternities between December 2017 and February 2018 was undertaken. Of these, 372 mothers had both pre- and post-partum hemoglobin (Hb) were recorded. Regression analyses were performed to investigate the relationship between change in Hb adjusted for red cell transfusion and QBL. Results: The correlation coefficient between QBL and adjusted change in Hb for all deliveries (n = 372) was 0.57. This corresponded to an estimated fall of adjusted change in Hb of 15.3 g/L (95% CI: 13.1, 17.6) per 1000 mL blood loss. Discussion: QBL has been shown to be reliable across all maternity settings, with reproducible results in theater and delivery rooms (on the obstetric unit and alongside midwifery-led unit). QBL is moderately correlated with adjusted change in Hb for all volumes of bleeding and gives clinicians more accurate knowledge of blood loss than visual estimation. This low-cost, low-fidelity intervention can influence the timely escalation of clinical care and therefore patient outcome.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Publisher: Informa Healthcare
ISSN: 1476-7058
Date of First Compliant Deposit: 18 June 2020
Date of Acceptance: 20 April 2020
Last Modified: 08 Nov 2023 13:18

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