Relación entre la pérdida sanguíneaestimada y la pérdida sanguínea calculada en partos por cesárea en nulíparas

Jorge Luis Casquero León; Giancarlo Andreé Valle González; Juan Carlos Ávila Alegría; José Raúl Paredes Salas; Luis Arturo Pedro Saona Ugarte

doi:10.31403/rpgo.v58i83

Authors

Jorge Luis Casquero León Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Giancarlo Andreé Valle González Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Juan Carlos Ávila Alegría Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
José Raúl Paredes Salas Médico Especialista en Obstetricia y Ginecología, Hospital Nacional Cayetano Heredia, Lima, Perú
Luis Arturo Pedro Saona Ugarte Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú. Médico Especialista en Obstetricia y Ginecología, Hospital Nacional Cayetano Heredia, Lima, Perú. Profesor Principal, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú

DOI:

https://doi.org/10.31403/rpgo.v58i83

Abstract

Objectives: To correlate visually estimated blood loss (vEBL) with calculated estimated blood loss (cEBL) during cesarean delivery in nulliparous women. Design: correlation retrospective study. Setting: Cayetano Heredia National Hospital, Lima, Peru. Participants: Nulliparous women subjected to cesarean section. Interventions: Medical records of 160 nulliparous women atended for cesarean deliveries at term during 2011 were reviewed. Data were statically analyzed with STATA V10.1 for Windows program. Main outcome measures: Blood loss. Results: Median vEBL and cEBL were respectively 500 mL (500–600 mL) and 421.4 mL (319.85–559.65 mL) with statistical significant difference, p < 0.001. For cEBL 1 000 mL median was 1 207.80 mL (1 039.60–1 419.00 mL) and vEBL median was 500 mL (500–600 mL) with statistical significant difference, p < 0.001. Hematocrit descended 3% (3–4%). Spearman correlation coefficient between vEBL and cEBL was 0.302 (p < 0.001). Conclusions: A statistically significant weak correlation was found between vEBL and cEBL. For intrapartum bleeding less than 500 mL vEBL was overestimated and for intrapartum bleeding greater than 1 000 mL (post partum hemorrhage), vEBL was also underestimated. Visual estimation of intrapartum bleeding showed inaccurate to calculate blood loss volume. Effective alternatives methods are required that include an estimated maternal blood volume formula and changes in hematocrit. Key words: Postpartum hemorrhage, visually estimated blood loss, calculated estimated blood loss, pregnancy blood volume, primary cesarean-section.

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