Measurement of blood loss at childbirth and postpartum

Received 1 March 2006; received in revised form 17 May 2006; accepted 17 June 2006. published online 13 July 2006.

Abstract

Objective

To accurately measure blood loss during childbirth in a developing country.

Method

The alkaline hematin technique was used to quantify blood lost during delivery and 24 h postpartum in 158 women in Pemba Island, Zanzibar.

Result

Women were found to lose less blood during childbirth and 24 h postpartum than previously reported. Compared with laboratory values, nurse–midwives approximated blood loss accurately (mean difference, i.e., mean underestimation by nurse–midwives, 4.90 mL); however, their imprecision was greater for higher laboratory values.

Conclusion

This study may prompt further investigation, as no comparable data exist for developing countries where maternal mortality is high and severe anemia prevalent.

Keywords: Alkaline hematin, Postpartum hemorrhage (PPH), Blood loss, Delivery, Estimation, Africa

a Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, USA

b Pemba Public Health Laboratory, Pemba Island, Zanzibar, Tanzania

c Cornell University, Division of Nutritional Sciences, Ithaca, NY, USA

d Johns Hopkins University Hospital, Department of Gynecology and Obstetrics, Baltimore, MD, USA

Corresponding author. Tel./fax: +1 410 955 2786/0196.

PII: S0020-7292(06)00308-0

doi:10.1016/j.ijgo.2006.06.010

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