Factors that predict low hematocrit levels in the postpartum patient after vaginal delivery.
OBJECTIVE
The purpose of this study was to provide a viable alternative to routine postpartum hematocrit measurement, by a determination of the clinical risk factors that identify patients with anemia and an examination of the resulting cost savings.


METHODS
In this retrospective review, cases (postpartum hematocrit level, <26%; subgroup hematocrit level, <23%) and control subjects were culled from the records of all vaginal deliveries from February 1997 to July 1998. Charts were reviewed for demographic characteristics, medical history, nursing assessments, and postpartum hematocrit measurements. Logistic regression modeling determined the best set of risk factors for the identification of low postpartum hematocrit levels.


RESULTS
From 1484 vaginal deliveries, 117 of the women (8%) had postpartum hematocrit levels of <26%. Estimated blood loss of >500 mL, Hispanic ethnicity, dizziness, or third- or fourth-degree laceration were the factors that identified 82.9% of the women with hematocrit levels of <26% and identified 97.4% of the women with hematocrit levels of <23%. Only 39.3% of the women would have required postpartum hematocrit measurement to obtain these detection rates.


CONCLUSIONS
Four risk factors (estimated blood loss of >500 mL, Hispanic ethnicity, dizziness, and third- or fourth-degree laceration) can safely determine the necessity of a postpartum hematocrit measurement.
Petersen
Linda A
LA
Department of Nursing, Children's and Women's Services, University of Iowa Hospitals and Clinics, Iowa City, USA.
Lindner
Deborah S
DS
Kleiber
Charmaine M
CM
Zimmerman
M Bridget
MB
Hinton
Almira T
AT
Yankowitz
Jerome
J
D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D001803:Blood Transfusion; D036861:Delivery, Obstetric; D004244:Dizziness; D005006:Ethnicity; D005260:Female; D006400:Hematocrit; D006630:Hispanic or Latino; D006801:Humans; D022125:Lacerations; D016015:Logistic Models; D006473:Postpartum Hemorrhage / Q000150:complications; D011247:Pregnancy; D011644:Puerperal Disorders; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D014621:Vagina / Q000293:injuries