Estimate of the Amount of Blood Loss after Cesarean Section by Different Methods and Analysis the Related Risk Factors of the Blood Loss More than 500 ml
- VernacularTitle:不同方法对剖宫产术后出血量的估计及出血量大于500ml的危险因素分析
- Author:
Yan ZHOU
;
Bin YAN
- Keywords:
Cesarean section;
High risk factors;
Blood loss
- From:
Journal of Practical Obstetrics and Gynecology
2017;33(6):461-464
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To choose a best method of estimating the amount of blood loss after cesarean deliveryby comparing of three methods,to analyze the related factors of the amount of the blood loss more than 500ml after cesarean section.Methods:We collected the clinical data of the patients who were accepted cesarean delivery and treated in our hospital between January 2014 and December 2014.We estimate the amount of blood loss by different methods(including visually estimated,hematocrit (HCT) change and formula).Based on the formula method as the gold standard,we analyze the risk factors of the patients whose blood loss were more than 500 ml.Results:Among the 583 patients,using the method of visually estimated,there were 23 cases whose blood loss were more than 500 ml(3.95%),using the method of formula,there were 133 cases whose blood loss were more than 500 ml (22.81%),using the method of HCT change,there were 116 cases whose blood loss were more than 500 ml(19.90%).The incidence of patients whose blood loss were more than 500 ml between HCT change and formula method showed no significant difference(P > 0.05),but the incidence by visually estimated method was less than the two other methods (P < 0.05).We found the value of HCT change was a statistically significant positive correlation with the amount of blood loss more than 500ml.When the blood loss was more than 500 ml,the accuracy and sensitiveness of HCT method were significantly higher than those of visually estimated method(76.69%,87.93% vs 12.78%,73.91%,respectively).Abnormal labor,uterine leiomyoma,placental factors,and macrosomia were risk factors of cases whose blood loss more than 500ml.Conclusions:HCT method is similar in accessing the blood loss after cesarean section with formula method,especially in the cases whose blood loss was more than 500 ml;HCT method is more convenient than formula method,and more accurate than visually estimated method.HCT method can be used as the standard for estimating blood loss initially,and formula method should be used as the method for estimating the blood loss accurately.Patients with macrosomia and abnormal labor are more likely to occur massive hemorrhage after cesarean section.