Wednesday, April 13, 2022

PPH - predictor

Q: Which of the following is a good predictor of postpartum hemorrhage (PPH)? (select one)

A) low fibrinogen 
B) hypotension
C) tachycardia
D) low hematocrit 


Answer: A

Low blood pressure and tachycardia usually do not manifest in pregnant patients till late and are a poor indicator of ongoing PPH (choice B and C). On the same token, in severe acute hemorrhage, it takes time before hematocrit shows a drop in the laboratory (choice D).

A fibrinogen level below 200 mg/dL is a reliable predictor of severe PPH, where massive blood transfusion or surgical/procedural intervention is required (choice A).

#ob-gyn
#surgical-critical-care


Reference:

1. Bell SF, Collis RE, Bailey C, et al. The incidence, aetiology, and coagulation management of massive postpartum haemorrhage: a two-year national prospective cohort study. Int J Obstet Anesth 2021; 47:102983.

2. Bonnar J. Massive obstetric haemorrhage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14:1.

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