Estimate Of The Amount Of Blood Loss By Different Methods And The Related Risk Factors Of Postpartum Hemorrhage

Objective: Through the comparison of the amount of blood loss after cesarean delivery by visually estimated, Hematocrit(HCT) change and formula, to analysis the related factors of the amount of the blood loss more than 500 ml, and provided the help for the early prevention of postpartum hemorrhage(PPH).Method: We collected the clinical data of the patients who were accepted cesarean delivery and treated at the First Affiliated Hospitals of Dalian Medical University between January 2014 and December 2014.We estimate the amount of blood loss by different methods. Based on the formula method as the gold standard, we analysis the pathogenesis of the patients whose blood loss were more than 500 ml. Statistical analysis was performed using SPSS 16. Chi-square or Fisher’s exact tests, t-tests, log-rank tests were used to analysis the data. P< 0.05 was considered statistically significant. We selected and assessed the risk factors of the PPH.Results: According to the exclusion criteria and inclusion criteria, 583 patients were analyzed. Used the method of formula to estimate the patients with the amount of blood loss more than 500 ml were 133(22.81%), used the method of visually estimated, there were 23(3.95%) patients, with the method of HCT change, there were 116(19.90%) patients. The incidence between HCT change and formula method was almost no significant difference, but the incidence by visually estimated was less than others. Compared the change of HCT, we found the value of HCT change was a statistically significant positive correlation with the amount of blood loss more than 500 ml. As the difference between the amount of blood loss of visually estimated and actual measurement increase grandly, the amount of blood loss actual measurement was increase grandly, we could consider the method of visually estimated was not accurately. Among the 133 patients, 102 patients were detected by the method of HCT, and only 23 patients were detected by the method of visually estimated. There was significant difference between two methods. Based on the results of the log-rank tests, we found four risk factors enter the model, they were abnormal labor, uterine leiomyoma, macrosomia and placental factors.Conclusion: The incidence between HCT change and formula method was almost no significant difference, but the incidence by visually estimated was less than others. It is very important to choose an effectively and easily method to estimate the accurate measurement of the blood loss and it is helpful for the clinical work. Uterine atony was also the high risk factor of PPH, and the macrosomia was the highest risk factor in uterine atony in our study.