Hemoglobin drop following postpartum hemorrhage

Abstract Postpartum hemorrhage (PPH) is defined as blood loss of ≥ 500–1000 ml within 24 h after delivery. Yet, assessment of blood loss is imprecise. The present study aimed to profile the hemoglobin (Hb) drop after vaginal delivery with versus without PPH. This was a secondary analysis of a prospe...

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Autores principales:	Enav Yefet, Avishag Yossef, Abeer Suleiman, Aliza Hatokay, Zohar Nachum
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/15e261d70cb847c7a94aafdf6a5dafbb
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spelling	oai:doaj.org-article:15e261d70cb847c7a94aafdf6a5dafbb2021-12-02T12:33:05ZHemoglobin drop following postpartum hemorrhage10.1038/s41598-020-77799-02045-2322https://doaj.org/article/15e261d70cb847c7a94aafdf6a5dafbb2020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77799-0https://doaj.org/toc/2045-2322Abstract Postpartum hemorrhage (PPH) is defined as blood loss of ≥ 500–1000 ml within 24 h after delivery. Yet, assessment of blood loss is imprecise. The present study aimed to profile the hemoglobin (Hb) drop after vaginal delivery with versus without PPH. This was a secondary analysis of a prospective cohort study of women who delivered vaginally. Women were included if complete blood counts (CBC) before and after delivery were taken until stabilization (N = 419). Women were categorized into the PPH group and controls, for whom post-delivery CBCs were performed due to indications unrelated to bleeding. The PPH patients were then classified as either overt or occult PPH (symptoms related to hypovolemia without overt bleeding) subgroups. The primary endpoint was mean Hb drop after delivery. One hundred and ten (26%) and 158 (38%) women presented with overt PPH or occult PPH, respectively; 151 (36%) women were included in the control group. Mean Hb decrease from baseline was 3.0 ± 1.6, 2.0 ± 1.4 and 0.9 ± 1.0 g/dl, respectively (p < 0.0001). In all groups, maximal rate of Hb decline was in the first 6–12 h postpartum and plateaued after 24–48 h. At 48 h post-delivery, 95% and 86% of women who had dropped to Hb ≤ 9.5 and < 7 g/dl, respectively, reached those thresholds. Taken together, an Hb decrease ≥ 2 g/dl was consistent with PPH diagnosis and should be followed for at least 48 h after delivery.Enav YefetAvishag YossefAbeer SuleimanAliza HatokayZohar NachumNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Enav Yefet Avishag Yossef Abeer Suleiman Aliza Hatokay Zohar Nachum Hemoglobin drop following postpartum hemorrhage
description	Abstract Postpartum hemorrhage (PPH) is defined as blood loss of ≥ 500–1000 ml within 24 h after delivery. Yet, assessment of blood loss is imprecise. The present study aimed to profile the hemoglobin (Hb) drop after vaginal delivery with versus without PPH. This was a secondary analysis of a prospective cohort study of women who delivered vaginally. Women were included if complete blood counts (CBC) before and after delivery were taken until stabilization (N = 419). Women were categorized into the PPH group and controls, for whom post-delivery CBCs were performed due to indications unrelated to bleeding. The PPH patients were then classified as either overt or occult PPH (symptoms related to hypovolemia without overt bleeding) subgroups. The primary endpoint was mean Hb drop after delivery. One hundred and ten (26%) and 158 (38%) women presented with overt PPH or occult PPH, respectively; 151 (36%) women were included in the control group. Mean Hb decrease from baseline was 3.0 ± 1.6, 2.0 ± 1.4 and 0.9 ± 1.0 g/dl, respectively (p < 0.0001). In all groups, maximal rate of Hb decline was in the first 6–12 h postpartum and plateaued after 24–48 h. At 48 h post-delivery, 95% and 86% of women who had dropped to Hb ≤ 9.5 and < 7 g/dl, respectively, reached those thresholds. Taken together, an Hb decrease ≥ 2 g/dl was consistent with PPH diagnosis and should be followed for at least 48 h after delivery.
format	article
author	Enav Yefet Avishag Yossef Abeer Suleiman Aliza Hatokay Zohar Nachum
author_facet	Enav Yefet Avishag Yossef Abeer Suleiman Aliza Hatokay Zohar Nachum
author_sort	Enav Yefet
title	Hemoglobin drop following postpartum hemorrhage
title_short	Hemoglobin drop following postpartum hemorrhage
title_full	Hemoglobin drop following postpartum hemorrhage
title_fullStr	Hemoglobin drop following postpartum hemorrhage
title_full_unstemmed	Hemoglobin drop following postpartum hemorrhage
title_sort	hemoglobin drop following postpartum hemorrhage
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/15e261d70cb847c7a94aafdf6a5dafbb
work_keys_str_mv	AT enavyefet hemoglobindropfollowingpostpartumhemorrhage AT avishagyossef hemoglobindropfollowingpostpartumhemorrhage AT abeersuleiman hemoglobindropfollowingpostpartumhemorrhage AT alizahatokay hemoglobindropfollowingpostpartumhemorrhage AT zoharnachum hemoglobindropfollowingpostpartumhemorrhage
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Hemoglobin drop following postpartum hemorrhage

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