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Diagnostic Performance of Serial bedside Capillary Lactate, Hemoglobin, and Shock Index for Severe Postpartum

Advances in Reproductive Sciences 2021年第4期9卷 189-198页

作者： Roberto Arturo Castillo-Reyther Idelia Natalie Plata-Alcocer Salvador De la Maza-Labastida venance basil kway Ma. del Pilar Fonseca-Leal Department of Obstetrics and Gynecology Hospital Central Dr. Ignacio Morones Prieto San Luis Potosi Mexico Research and Clinical Postgraduate Department of the Faculty of Medicine Universidad Autonoma de San Luis Potosi Mexico

Objective: To assess the diagnostic capacity of bedside capillary lactate (CLact), capillary Haemoglobin (CHb), and shock index (SI) for severe postpartum haemorrhage (SPPH > 2000 ml) at diagnosis, 15 minutes and 30 minutes later. Method: A cohort study was carried out in a reference hospital in San Luis Potosi, Mexico from February 2020 to March 2021, and included sixty women in vaginal labor or c-section who presented PPH (≥500 ml in labor or ≥1000 ml in c-section) measured by the gravimetric method. CLact, SI, and CHb concentrations were analyzed at diagnosis of PPH, 15 minutes, and 30 minutes. Patients who presented total blood loss of >2000 ml were considered SPPH. A T-test or Wilcox test was performed to compare the groups of non-severe and severe. Sensitivity, specificity, and performance were calculated by A Receiver Operating Curve. Results: A CLact measurement at 30 minutes was significantly different between the non-severe and severe groups (4.0 + 1.9 vs 4.8 + 1.15 P-value 0.001, with an optimal cut point of 4.3 mmol/dl at AUC 0.75, sensitivity 0.85, and specificity of 0.62. With a cut-point of 1.17, an AUC of 0.76, sensitivity of 0.43, and specificity of 0.98, SI at diagnosis was significantly different between the non-severe and severe groups (0.70 + 0.20 vs. 0.90 + 0.38 P-value 0.0228). Conclusion: SI is an early sign of SPPH;CLact can significantly identify SPPH after 30 minutes.

关键词： Capillary Haemoglobin Lactate Obstetric Haemorrhage Shock Index

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Diagnostic Performance of Serial bedside Capillary Lactate, Hemoglobin, and Shock Index for Severe Postpartum

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Advances in Reproductive Sciences 2021年第4期

作者： Roberto Arturo Castillo-Reyther Idelia Natalie Plata-Alcocer Salvador De la Maza-Labastida venance basil kway Ma.del Pilar Fonseca-Leal

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