title: Factors that predict low hematocrit levels in the postpartum patient after vaginal delivery.
abstract: 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.
authors.affiliation: Department of Nursing, Children's and Women's Services, University of Iowa Hospitals and Clinics, Iowa City, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Petersen
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Lindner
authors.forename: Charmaine M
authors.initials: CM
authors.lastname: Kleiber
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Zimmerman
authors.forename: Almira T
authors.initials: AT
authors.lastname: Hinton
authors.forename: Jerome
authors.initials: J
authors.lastname: Yankowitz
mesh_terms: 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