RT Book, Section
A1 Cunningham, F. Gary
A1 Leveno, Kenneth J.
A1 Dashe, Jodi S.
A1 Hoffman, Barbara L.
A1 Spong, Catherine Y.
A1 Casey, Brian M.
SR Print(0)
ID 1190763437
T1 Management of Obstetrical Hemorrhage
T2 Williams Obstetrics, 26e
YR 2022
FD 2022
PB McGraw Hill
PP New York, NY
SN 9781260462739
LK accessmedicine.mhmedical.com/content.aspx?aid=1190763437
RD 2024/04/23
AB Recognition  of  obstetrical  hemorrhage  severity  is  crucial  to  its  management.  However,  visual  estimates,  especially  when  blood  losses  are  excessive,  are  notoriously  inaccurate.  In  many  cases,  true  volume  losses  are  often  two  to  three  times  the  clinical  estimate.  Moreover,  in  obstetrics,  part  and  sometimes  even  all  of  the  lost  blood  may  be  concealed.  Estimation  is  further  complicated  in  that  peripartum  hemorrhage  also  includes  the  pregnancy-augmented  blood  volume.  After  pregnancy  hypervolemia  is  lost  at  delivery,  blood  loss  can  be  estimated  by  calculating  500  mL  loss  for  each  3  volume  percent  drop  in  hematocrit.  Its  nadir  depends  on  the  speed  of  resuscitation  with  intravenous  crystalloids  and  blood  products.  With  ongoing  blood  loss,  the  real-time  hematocrit  is  at  its  maximum  whenever  measured  in  the  delivery,  operating,  or  recovery  room.