Quantification of blood loss in obstetric haemorrhage: intervention & transfusion TOFG 2023 Flashcards
What is the comments cause of significant bleeding in pregnancy?
PPH
2% women world wide
Leading cause of maternal mortality worldwide?
Haemorrhage
27% of all maternal death
Most common cause admission to ITU in obstetric patients
PPH
As per RCOG categorisation of blood loss
- Minor
- Major - moderate
- Major - severe
- Minor >500-1000
- Major - moderate 1000-2000
- Major - severe >2000
Table explaining estimated blood volumes per weight
Each 10kg, 1000ml more TBV
What proportion on UK deliveries have blood loss >500mls?
25%
> 1000ml 10%
2000mls <1%
Most common cause of death from blood transfusion?
TACO
Risk of alloimmunisation in transfused patients
1-6%
% of blood flow to uterus ar term?
15%
700ml/min
What are the 2 quantitive measurement of blood loss
Gravimetric - weigh swabs and substract dry weight
Volumetric - mesure blood loss from under buttock drape
Table explaining feature methods of measurement of blood loss
Which form of measure is used as gold standard when comparing other methods?
Photometric analysis using alkaline haematin method
+/- 10% blood loss
20 hours to complete
How is shock index calculated?
Normal outside pregnancy
High in pregnancy
HR/SBP
Non obstetric normal 0.5-0.7
Obstetric >0.9 - increased risk BT, ITU, intervention
What significant changes to haemostats is seen after delivery of the placenta?
Increase in fibrinolysis, exacerbate PPH
How long can it take for Hb to drop in haemorrhage
6 hours
Hb measurements in active haemorrhage not accurate
OBS Cymru algorithm
