title: Diagnosing Postpartum Hemorrhage: A New Way to Assess Blood Loss in a Low-Resource Setting.
abstract: Introduction Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. The largest barriers to treating PPH are symptom recognition and timely diagnosis. The SAPHE (Signaling a Postpartum Hemorrhage Emergency) Mat was constructed so that each square on the Mat absorbs up to 50 mL of blood. The objective of this study was to evaluate the correlation of visually estimated blood loss (EBL) using the SAPHE Mat with actual blood loss. Methods Thirty-six patients gave birth via vaginal delivery using the SAPHE Mat. Visual estimation of blood loss using the SAPHE Mat was calculated by multiplying the number of blood- saturated squares or partial squares by 50 mL. The visual EBL was compared with the actual blood loss calculated based on Mat weight before and after use (volume blood loss). Results Visual blood loss estimations were within 100 mL of the volume blood loss 69 % of the time and within 200 mL 97 % of the time. The mean difference between the visual EBL and volume blood loss (Mat weight change) was 80.91 mL. The Pearson correlation coefficient for visual EBL and volume blood loss was positive at 0.96 (p < 0.001). Discussion The SAPHE Mat is able to provide a visual estimate of blood loss that is highly correlated with the actual blood loss on the mat. Future studies will assess the ability to deploy the SAPHE Mat in low-resource settings as a potential guide for estimating blood loss to assist in improved management of PPH.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main St, Ste 1096, Houston, TX, 77030, USA. LLWilcox11@gmail.com.
authors.forename: Lorine
authors.initials: L
authors.lastname: Wilcox
authors.affiliation: Rice University, 6100 Main Street, Houston, TX, 77005, USA.
authors.forename: Chethan
authors.initials: C
authors.lastname: Ramprasad
authors.affiliation: Rice University, 6100 Main Street, Houston, TX, 77005, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Gutierrez
authors.affiliation: Department of Bioengineering, Rice University, 6000 Main Street, Houston, TX, 77005, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Oden
authors.affiliation: Department of Bioengineering, Rice University, 6000 Main Street, Houston, TX, 77005, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Richards-Kortum
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main St, Ste 1096, Houston, TX, 77030, USA.
authors.forename: Haleh
authors.initials: H
authors.lastname: Sangi-Haghpeykar
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main St, Ste 1096, Houston, TX, 77030, USA.
authors.forename: Manisha
authors.initials: M
authors.lastname: Gandhi
mesh_terms: D041342:Absorbent Pads / Q000592:standards*; D000328:Adult; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D006473:Postpartum Hemorrhage / Q000175:diagnosis*; D011247:Pregnancy; D013223:Statistics as Topic / Q000295:instrumentation* / Q000592:standards
keywords: Estimated blood loss; Low-resource setting; Postpartum hemorrhage; SAPHE Mat; Vaginal delivery