Quantitative Blood Loss in Obstetric Hemorrhage: ACOG COMMITTEE OPINION, Number 794.

Abstract

Postpartum hemorrhage causes approximately 11% of maternal deaths in the United States and is the leading cause of death that occurs on the day of birth. Importantly, 54-93% of maternal deaths due to obstetric hemorrhage may be preventable. Studies that have evaluated factors associated with identification and treatment of postpartum hemorrhage have found that imprecise health care provider estimation of actual blood loss during birth and the immediate postpartum period is a leading cause of delayed response to hemorrhage. Although current data do not support any one method of quantifying blood loss as superior to another, quantification of blood loss, such as using graduated drapes or weighing, provides a more accurate assessment of actual blood loss than visual estimation; however, the effectiveness of quantitative blood loss measurement on clinical outcomes has not been demonstrated. Successful obstetric hemorrhage bundle implementation is associated with improved outcome measures related to obstetric hemorrhage. However, further research is necessary to better evaluate the particular effect of quantitative blood loss measurement in reducing maternal hemorrhage- associated morbidity in the United States.