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Bleeding after intravascular transfusion: experimental and clinical observations
M Segal1, F A Manning, C R Harman
1Division of Maternal-Fetal Medicine, University of Manitoba, Winnipeg, Canada.
American Journal of Obstetrics and Gynecology
|November 1, 1991
Summary
Postpuncture bleeding from umbilical vessels was studied using an in vitro model and in vivo observations. Bleeding duration varied by vessel, needle size, and fetal platelet count, helping to define blood loss ranges.
Area of Science:
- Perinatology
- Fetal Medicine
- Vascular Access
Background:
- Umbilical vessel puncture is a common procedure in fetal medicine.
- Assessing and quantifying postpuncture bleeding is crucial for patient safety.
- Variability in bleeding characteristics necessitates further investigation.
Purpose of the Study:
- To evaluate the characteristics of postpuncture bleeding in umbilical vessels.
- To establish methods for quantifying blood loss after umbilical vessel procedures.
- To correlate bleeding parameters with procedural and fetal factors.
Main Methods:
- Utilized an in vitro human umbilical cord perfusion model.
- Employed in vivo ultrasonographic observation of bleeding duration.
- Analyzed factors influencing bleeding duration including vessel type, needle size, and fetal platelet count.
Main Results:
- In vitro ultrasonography demonstrated high sensitivity (0.01 ml/sec) for detecting blood loss.
- In vitro blood loss correlated with perfusion rate but showed significant inter-specimen variability.
- Clinical bleeding was observed in 43% of cases, with duration dependent on specific variables.
Conclusions:
- Combined in vitro and in vivo data provide a comprehensive understanding of postpuncture bleeding.
- The study helps define the expected range of bleeding duration and probable blood loss volumes.
- Findings can inform clinical practice regarding risk assessment and management of umbilical vessel procedures.