Postpartum Blood Loss: A Case Study

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Current Practice
Visual estimation of blood loss (vEBL) is the current global standard practice for measuring postpartum blood loss (Diaz, Abalos, & Carroli, 2014). In current practice, a healthcare provider visually observes the amount of blood lost during and after delivery and records a quantitative value. Once out of the providers direct care the patients nurse continues to monitor blood loss by simply visually estimating how much blood has soaked into the patient’s maternity pad. According to the Association of Women’s Health, Obstetrics, and Neonatal Nurses (AWHONN) (2015), visual estimation can underestimate actual blood loss leading to the delay of life-saving interventions. Delayed intervention and failure to recognize blood loss are …show more content…
The definition of postpartum hemorrhage is “active bleeding greater than 500ml for Vaginal deliveries and greater than 1000ml for C-sections, within 24 hours following birth that continues despite the use of initial measures including first-line uteronic agents and uterine massage” (Abdul-Kadir et al., 2014). It is key to know and understand the definition of PPH to intervene appropriately to manage PPH. This correlation is problematic because Postpartum hemorrhage (PPH) remains the “leading cause of maternal morbidity and mortality in the world” (WHO, 2012). The California Maternal Quality Care Collaboration (CMQCC) (2014), reports Visual estimation significantly underestimates large volumes by 35-50% when compared to direct measurements. Inaccurate measurements can also lead to overestimation which can cause unnecessary treatments such as blood transfusions that expose women to unnecessary risks, and can be costly to the patient and hospital …show more content…
For the purposes of this paper research evidence was found using PubMed, CINHAL, Medline and the Cochran databases using search phrases, “Estimated Blood Loss AND Birth”, “Blood Loss AND Measurement AND Birth”, “Blood Loss AND Post-Partum Hemorrhage”, and “Blood Loss Measurements AND Labor AND PPH”. A PICO question was generated as well with the following components; P-Postpartum Women, I- Visually Estimated Blood Loss, C- Quantified Blood Loss, O- Inaccurate Measurement of Blood Loss during birth. Research was also found by searching the American Congress of Obstetrics and Gynecologists (ACOG), the Association of Women’s Health, Obstetrics, and Neonatal Nurses (AWHONN), and the California Maternal Quality Care Collaborative websites (CMQCC), as these resources are of high credibility.
Due to the vast amount of information available, the search for evidence was filtered to include only sources published within the last ten years. Some other limitations placed on the search include only articles written in English were considered, and only articles with abstracts were selected for ease of sifting through
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