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Assessing Accuracy of Blood Loss Measurements During Cesarean Birth in a Diverse Patient Population: A Quality

Jessica Jf Kram1,2, Yuri Zermeno3, James O Adefisoye4

  • 1Academic Affairs, Aurora University of Wisconsin Medical Group, Advocate Health, Aurora Sinai Medical Center, Milwaukee, Wisconsin, jessica.kram@aah.org.

WMJ : Official Publication of the State Medical Society of Wisconsin
|February 5, 2025
PubMed

Insights

Accurate measurement of blood loss during delivery is crucial. Quantitative blood loss and estimated blood loss are readily available but less accurate than calculated blood loss, highlighting the need for better postpartum hemorrhage detection tools.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Measurement

Background:

  • Accurate measurement of blood loss during delivery is critical for the early detection of postpartum hemorrhage.
  • Existing methods for assessing blood loss include estimated blood loss (EBL) and quantitative blood loss (QBL).

Purpose of the Study:

  • To compare the accuracy and clinical utility of estimated blood loss (EBL) and quantitative blood loss (QBL) against calculated blood loss (CBL) in cesarean deliveries.
  • To evaluate the sensitivity, specificity, and predictive values of EBL and QBL in identifying postpartum hemorrhage.

Main Methods:

  • A retrospective review of cesarean deliveries between December 1, 2018, and December 1, 2019.
  • Comparison of EBL and QBL measurements with CBL, determined using a standard formula.
  • Analysis of sensitivity, specificity, and negative predictive values for EBL and QBL.

Main Results:

  • Median EBL (600.0 mL) and QBL (557.0 mL) were significantly lower than median CBL (929.4 mL) (P < 0.001).
  • Both EBL and QBL demonstrated low sensitivity and low negative predictive values for postpartum hemorrhage detection.
  • QBL identified only 10 additional patients with postpartum hemorrhage compared to CBL.

Conclusions:

  • While EBL and QBL are immediately available, they are less accurate than CBL and have limitations in detecting postpartum hemorrhage.
  • Current methods for measuring blood loss during delivery have shortcomings.
  • There is an ongoing need for the development of reliable tools for accurate blood loss assessment in clinical practice.
Abstract

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