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Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss

  • Rubinnis Gutierrez-Disla , Joshua Fogel and Allan J. Jacobs EMAIL logo
Published/Copyright: August 2, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 8

Abstract

Objectives

Hemorrhage risk assessment tools have been studied using estimated blood loss. We study the association between peripartum hemorrhage risk assessment score and peripartum quantified blood loss (QBL) in term vaginal and cesarean deliveries.

Methods

This is a retrospective analysis conducted on 3,657 patients who underwent term vaginal and cesarean deliveries at a public hospital in New York City. Utilizing the risk assessment tool developed by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), patients were categorized into low-, medium-, or high-risk groups for postpartum hemorrhage.

Results

Medium-risk (B=0.08, SE=0.01, p<0.001) and high-risk (B=0.12, SE=0.02, p<0.001) AWHONN scores were associated with significantly higher QBL as compared to low-risk AWHONN score. Medium-risk approached significance (OR: 1.67, 95 % CI: 1.00, 2.79, p=0.050) and high-risk AWHONN score was significantly associated (OR: 1.95, 95 % CI: 1.09, 3.48, p=0.02) with increased odds for postpartum hemorrhage (≥1,000 mL). Each individual factor comprising the AWHONN score whose percentage in our sample was seen in greater than 2.7 % of patients was independently significantly associated with increased QBL (six of nine factors) and postpartum hemorrhage (four of nine factors).

Conclusions

The AWHONN measure previously validated with estimated blood loss predicted obstetric blood loss with QBL. Although not on the basis of the data shown in our study, we believe that QBL should be routinely used to measure obstetric blood loss.

Keywords: postpartum hemorrhage; obstetric delivery; risk assessment; obstetric labor complications; quantified blood loss
Corresponding author: Allan J. Jacobs, MD, JD, Department of Obstetrics and Gynecology, NYC/H+H – South Brooklyn Health, 2601 Ocean Parkway, Brooklyn, NY 11235, USA; and Department of Obstetrics and Gynecology, Downstate Medical Center, Brooklyn, NY, USA, E-mail:

  1. Research ethics: The local Institutional Review Board deemed the study exempt from review.

  2. Informed consent: Not applicable. A waiver for informed consent was obtained from the local Institutional Review Board due to the retrospective nature of the study.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The data are available upon reasonable request from the corresponding author.

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Received: 2024-04-21
Accepted: 2024-07-14
Published Online: 2024-08-02
Published in Print: 2024-10-28

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpm-2024-0187
Keywords for this article
postpartum hemorrhage; obstetric delivery; risk assessment; obstetric labor complications; quantified blood loss

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis
  4. Opinion Paper
  5. Non-binary patients in ART: new challenges and considerations
  6. Corner of Academy
  7. KANET evaluation in patients with SARS-CoV-2
  8. Original Articles – Obstetrics
  9. Socioeconomic status as a risk factor for SARS-CoV-2 infection in pregnant women
  10. Social vulnerability and prenatal diagnosis
  11. Perinatal outcomes in pregnant women with ITP: a single tertiary center experience
  12. Ability of an obstetric hemorrhage risk assessment tool to predict quantitative peripartum blood loss
  13. Sensitive detection of hemodynamic changes after fetoscopic laser photocoagulation by assessing intraventricular pressure difference in fetuses with twin-to-twin transfusion syndrome
  14. Prevalence of restless legs syndrome during pregnancy and postpartum period
  15. Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis
  16. Uterine isthmic tourniquet left in situ as a new approach for placenta previa-accreta surgery: a comparative study
  17. Maternal and newborn outcomes in pregnancies complicated by Guillain-Barré syndrome
  18. Original Articles – Fetus
  19. A customised fetal growth and birthweight standard for Qatar: a population-based cohort study
  20. Molecular analysis of 31 cases with fetal skeletal dysplasia
  21. Short Communication
  22. Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey
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