HEALTH OF WOMAN.2015.3(99):83–87; doi 10.15574/HW.2015.99.83

Semi-quantity method of postpartum visual blood loss estimation

Chernov A. V. 
National Medical Academy of Postgraduate Education P. L. Shupyk, Kiev

Visual estimation of postpartum blood loss is widely used in clinical practice all over the world. Traditionally visual estimation is utilized as a quantity method when blood volume is assessed in millilitres. The research shows low sensitivity of quantity visual estimation and high underestimation of blood volumes Ј300 мл. Proposed semi-quantity method is based on actual sensitivity of visual blood loss estimation, excludes the need to guess the volume of blood and demonstrates higher rate of correct estimation comparing to quantity method. Teaching can significantly improve the results of semi-quantity visual estimation of postpartum blood loss.

Key words: postpartum hemorrhage, postpartum blood loss, postpartum period.

REFERENCES 
1. WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization. 2012. 
2. WHO. The Prevention and Management of Postpartum Haemorrhage. Report of a Technical Working Group. Geneva 3–6 July 1989. Unpublished document. WHO/MCH/90.7.Geneva:World Health Organi-zation. 1990. 
3. WHO. Managing Complications in Pregnancy and Childbirth: A guide for midwives and doctors. Department of Reproductive Health and Research. Geneva: World Health Organization. 2003. 
4. Prevention and management of postpartum haemorrhage. Royal College of Obstetricians and Gynaecologists. Green-top Guideline 52. May 2009. Minor revisions November. 2009 and April 2011. 
5. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gyneco-logists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol 2006.108:1039–47. 
6. Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage 235. October 2009 (Replaces No. 88, April 2000). J Obstet Gynaecol Can 2009;31(10):980–993. PMid:19941729 
7. American College of Gynecologists and Obstetricians. Quality Assurance in Obstetrics and Gynecology. Washington DC: American College of Obstetricians and Gynecologists. 1989. 
8. Sobieszczyk S, Breborowicz GH. 2004. Management recommendations for postpartum hemorrhage. Arch Perinatal Med 10:1–4. 
9. Наказ МОЗ України від 24.03.2014 № 205 «Про внесення змін до наказів Міністерства охорони здоров’я України від 29 грудня 2005 року № 782 та від 31 грудня 2004 року № 676». Клінічний протокол «Акушерські кровотечі». 
10. Bose P, Regan F, Paterson-Brown S. 2006. Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical reconstructions. BJOG 113:919–24. http://dx.doi.org/10.1111/j.1471-0528.2006.01018.x; PMid:16907938 
11. Dildy GA 3rd, Paine AR, George NC, Velasco C. 2004. Estimating blood loss: can teaching significantly improve visual estimation? Obstet Gynecol 104:601–6. http://dx.doi.org/10.1097/01.AOG.0000137873.07820.34; PMid:15339775 
12. Duthie SJ, Ven D, Yung GL, Guang DZ, Chan SY, Ma HK. 1991. Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. Eur J Obstet Gynecol Reprod Biol 38:119–24. http://dx.doi.org/10.1016/0028-2243(91)90188-Q 
13. Newton M, Mosey LM, Egli GE, Gifford WB, Hull CT. 1961. Blood loss during and immediately after delivery. Obstet Gynecol 17:9–18. PMid:13728699 
14. Prasertcharoensuk W, Swadpanich U, Lumbiganon P. 2000. Accuracy of the blood loss estimation in the third stage of labor. Int J Gynaecol Obstet 71:69–70. http://dx.doi.org/10.1016/S0020-7292(00)00294-0 
15. Razvi K, Chua S, Arulkumaran S, Ratnam SS. 1996. A comparison between visual estimation and laboratory determination of blood loss during the third stage of labour. Aust NZ J Obstet Gynaecol 36:152–4. http://dx.doi.org/10.1111/j.1479-828X.1996.tb03273.x 
16. Stafford I, Dildy GA, Clark SL, Belfort MA. 2008. Visually estimated and calculated blood loss in vaginal and cesarean delivery. Am J Obstet Gynecol 199:519. http://dx.doi.org/10.1016/j.ajog.2008.04.049; PMid:18639209 
17. Sukprasert M, Choktanasiri W, Ayudhya NI, Promsonthi P, O-Prasertsawat P. 2006. Increase accuracy of visual estimation of blood loss from education programme, J Med Assoc Thai 89:S54–S59. PMid:17726810 
18. Al-Kadri et al. 2014. Effect of education and clinical assessment on the accuracy of postpartum blood loss estimation. BMC Pregnancy and Childbirth 14:110. http://dx.doi.org/10.1186/1471-2393-14-110; PMid:24646156 PMCid:PMC3994970 
19. Akhlaghi F, Bazargani VT. 2013, Sept. A Study on the Effect of Education by Using Simulation on Post partum Visual Blood Loss Estimation. Future of Medical Education Journal 3;3:29–34. 
20. Maslovitz S, Barkai G, Lessing JB, Ziv A, Many A. 2008. Improved accuracy of postpartum blood loss estimation as assessed by simulation. Acta Obstet Gynecol 87:929–934. http://dx.doi.org/10.1080/00016340802317794; PMid:18720041 
21. Moscati R, Billittier AJ, Marshall B, Fincher M, Jehle D, Braen R. 1999. Blood loss estimation by out-of-hospital emergency care providers. Prehosp Emerg Care 3:239–242. http://dx.doi.org/10.1080/10903129908958943; PMid:10424862 
22. Mark A. Merlin, Scott M. Alter, Brian Raffel, Peter W. 2009. Pryor External blood loss estimation using the MAR Method. American Journal of Emergency Medicine 27:1085–1090. http://dx.doi.org/10.1016/j.ajem.2008.07.039; PMid:19931755 
23. Чернов АВ, Голяновський ОВ, Камінський ВВ. Приймач для збирання піхвових виділень при акушерських та гінекологічних кровотечах. Патент на корисну модель u201001071 від 10.08.2010.