Assessment of postpartum hemorrhage in vaginal labor: a longitudinal study of repeatative measurement
10.3760/cma.j.issn.1674-2907.2017.10.001
- VernacularTitle:阴道分娩产后出血的评估与观察:一项重复测量的纵向研究
- Author:
Ying LIU
1
;
Qun HUANG
;
Wenqin YE
Author Information
1. 第二军医大学附属长海医院护理部
- Keywords:
Postpartum hemorrhage;
Risk assessment;
Clinical manifestation;
Repetitive measurement
- From:
Chinese Journal of Modern Nursing
2017;23(10):1333-1339
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the comprehensive clinical manifestations as postpartum assessment indicators of women with natural birth repeatedly and explore those closely related to postpartum hemorrhage (PPH) as evidence for clinical routine.Methods A self-designed buttock drape was used to collect blood after baby birth. The assessment indicators including temperature, blood pressure, pulse, respiratory rate, mean arterial pressure, shock index, arterial oxygen saturation, urine amount, contraction of uterus, height of fundus, symptoms of hemorrhagic shock as well as laboratory parameters (RBC, Hb, HCT, PLT), were recorded on a defined time schedule at the mean time. Maternal were divided into PPH group and non-PPH group according to the total amount of blood loss.Results A total 150 cases were included, with 71 cases turned out to be PPH group and 79 cases in non-PPH group. The incidence of PPH was approximately 47.3%. Of the two groups, differences of pulse between and within groups were statistically significant (P<0.05). Shock index and temperature showed significant differences between two groups (P<0.01). Uterus contraction and the height of fundus were significantly different within groups (P<0.05). The differences of RBC, Hb and HCT pre-delivery and post-delivery were significant between two groups (P<0.05).Conclusions The changes in pulse and shock index have clinical implications for the assessment of women occurring postpartum hemorrhage, which should be suggested of close monitoring. Temperature, blood pressure, mean arterial pressure, respiratory rate, arterial oxygen saturation, urine amount, contraction of uterus, height of fundus have less differences, allowing for prolonged intervals of observation. Laboratory parameters remain clinical values for medical staffs even with hysteresis.
