产科出血的基于体重和计算的血液损失之间的一致性:随机对照试验的前期研究
Linnea Skogvard1,2, Gita Strindfors1,2, Margit Endler2,3
1Department of Obstetrics and Gynecology, South General Hospital, Stockholm, Sweden.
概括
计算血液损失 (CBL) 公式高估了产后出血 (PPH) 与基于体重的血液损失 (WBBL) 相比. 这些CBL方法对于产科实践或研究中的PPH评估缺乏临床相关性.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 临床测量 临床测量
背景情况:
- 产后出血 (PPH) 是全球主要的孕产妇死亡原因.
- 精确测量血液损失对于PPH管理至关重要,但缺乏黄金标准.
- 量化流血的现有方法包括基于体重的流血量 (WBBL) 和各种计算流血量 (CBL) 公式.
研究的目的:
- 评估两种CBL公式和WBBL公式在阴道分娩期间量化流血的一致性.
- 在PPH的背景下确定CBL方法的临床实用性和研究适用性.
主要方法:
- 一项试点研究涉及妇女经历计划性阴道分娩在≥36个妊娠周.
- 使用WBBL,格罗斯公式 (基于血红素) 和产前后血红蛋白差异来测量血流.
- 统计分析包括威尔科克森的签名等级测试,斯皮尔曼的罗相关性和麦克纳马的PPH诊断一致性测试.
主要成果:
- 与WBBL相比,两种CBL方法都显著高估了血液损失 (p < 0.008).
- 在PPH诊断中,WBBL和Gross公式之间的一致性为61% (p=0.002),WBBL和Hb之间的差异为43% (p=0.001).
- 在WBBL和两种CBL方法之间观察到中等的正相关性 (p=0.001).
结论:
- 与基于体重的血液损失相比,计算的血液损失公式显示出显著的差异和高估.
- 尽管存在相关性,但不同的估计表明CBL方法不适合常规的临床产科实践或PPH评估研究.
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