Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis.
Mariana Torreglosa Ruiz, Nayara Freitas Azevedo, Cynthya Viana de Resende and 5 others
PMID 38055493WHAT IT FOUND
No single best way to measure blood loss after childbirth was proven, but any objective quantification method found more serious bleeding than visual estimation.
Key findings
01In included studies, visual estimation found fewer large postpartum losses than calibrated fields or colorimetry: it detected 2.1% of losses over 1,000 ml versus 6.5% by calibrated field, and one case versus 11 cases by colorimetry.
02The meta-analysis could not identify the most effective method for quantifying postpartum blood loss because the included studies were highly heterogeneous.
03Simulated training reduced error rates in judging losses over 500 ml; rates were 42% to 58% before training and 12% to 30% after.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were too different to combine into a clear answer about which method is best. Most studies were observational, and many participants were their own controls, so they cannot prove a method works. Blinding was not possible because the methods looked different, and some studies did not control for fluids such as amniotic fluid or urine. The review included simulated scenarios, which may not reflect routine care. Most evidence came from vaginal childbirth, and results may not apply equally to all settings or to cesarean births.
The easy way to misread this
Do not read this as proof that a single method, such as colorimetry or gravimetry, is the best choice for every unit. The review could not identify a most effective method because the study results varied widely.