Abstract:
Background Postpartum hemorrhage (PPH) is the most common complication of vaginal delivery and the leading cause of maternal mortality. The majority of deaths resulting from PPH are preventable, early detection and timely intervention are important. However, currently, the estimated blood loss in clinics tends to be underestimated, leading to missed opportunities for rescue.
Objective To explore a 24 h accurate measurement and early warning management model for PPH.
Methods The experimental group included 5 546 women who underwent vaginal delivery at Beijing Haidian Maternal and Child Health Hospital from January 2022 to May 2023. The control group comprised 5 967 women who delivered at the same hospital from August 2020 to December 2021. The experimental group implemented an accurate measurement and early warning management model for PPH, which involved prenatal risk assessment to identify high-risk factors, the use of labor measurement pad and postpartum blood collection pads for precise measurement of blood loss within 24 h after childbirth, and timely intervention based on predetermined warning thresholds. The main outcome measures included the accuracy of blood loss measurement, the incidence of PPH and severe PPH, and the prevalence of moderate to severe anemia.
Results The postpartum blood loss within 24 h in the experimental group was consistent with hemoglobin-adjusted blood loss and hematocrit-adjusted blood loss, showing no statistically significant differences (P>0.05). In contrast, the control group exhibited significantly lower blood loss compared to hemoglobin and hematocrit-adjusted blood loss (P<0.01). Our study revealed that the experimental group had lower postpartum blood loss at 2 h and 24 h, with values of (257.65 ± 69.89) mL and (419.42 ± 91.28) mL, respectively, which were significantly lower than those of the control group (280.34 ± 68.32 mL and 488.06 ± 108.36 mL, respectively) with statistically significant difference (P＜0.05). The incidence of PPH in the experimental group was lower than that in the control group (5.27% vs 9.73%, P<0.001), as well as the incidence of severe PPH (0.18% vs 0.45%, P<0.01), and the prevalence of moderate to severe anemia (3.30% vs 6.78%, P<0.001).
Conclusion The 24 h accurate measurement and early warning management model for PPH significantly improves the accuracy of blood loss estimation and effectively reduces the incidence of PPH, severe PPH, and moderate to severe anemia, which is worth promoting and implementing in clinical practice.
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