Accuracy of Blood Loss Measurement during Cesarean Delivery
Open accessAbstract
Objective This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland–Altman method. Results Compared with the blood loss measured by the reference assay (470 ± 296 mL), the colorimetric system (572 ± 334 mL) was more accurate than either visual estimation (928 ± 261 mL) or gravimetric measurement (822 ± 489 mL). The correlation between the assay method and the colorimetric system was more predictive (standardized coefficient = 0.951, adjusted R2 = 0.902) than either visual estimation (standardized coefficient = 0.700, adjusted R2 = 00.479) or the gravimetric determination (standardized coefficient = 0.564, adjusted R2 = 0.304). Conclusion During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes.
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In studies comparing visual EBL to colorimetric image analysis during cesarean birth, visual EBL was reported to overestimate blood loss.
“In studies to compare visual EBL to colorimetric image analysis during cesarean birth, researchers reported overestimation with the use of visual EBL (Doctorvaladan et al., 2017;Hire et al., 2020).”
From Quantification of Blood Loss: AWHONN Practice Brief Number 13 (2021) · cites this paper as Doctorvaladan et al., 2017
Using haemorrhage as an outcome for predictive modelling is limited because blood loss measurement is highly heterogeneous and often inaccurate, complicating comparisons between studies.
“using haemorrhage as an outcome for predicting modelling is limited as blood loss measurement is highly heterogenous and often inaccurate, hence complicating comparisons between studies using this as an outcome [39, 40]”
From Radiomics-based prediction of FIGO grade for placenta accreta spectrum (2023) · cites this paper as [39]
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References 26 · Cited by 65
Research works printed but not linked: 1
- [16]Hill S E Broomer B Stover J White W Accuracy of estimated blood loss in spine surgery. In: Proceedings of the American Society of Anesthesiologists (ASA) 2011 Annual Meeting; October 15–19, 2011 Chicago, IL. Abstract A054
- Authors
- Doctorvaladan, S., Jelks, A., Hsieh, E., Thurer, R., Zakowski, M., & Lagrew, D.
- Affiliations
- Santa Clara Valley Medical Center (US)
- Gauss Surgical, Inc., Los Altos, California
- Cedars-Sinai Medical Center (US)
- St. Joseph Health System (US)
- Corresponding author
- Lagrew, David
- Venue
- American Journal of Perinatology Reports
- Publisher
- Georg Thieme Verlag KG
- Published
- 2017-04
- Volume
- 07
- Issue
- 02
- Pages
- e93-e100
- ISSN
- 2157-6998 (ISSN-L)
- 2157-7005
- PMC
- PMC5425292
- OpenAlex
- W2612649359
- Semantic Scholar
- dd709f65fb3ad534b4a44e385d09cfa6756cf326
- Cited by
- 65
- References
- 26
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 8 · 2022: 4 · 2021: 11 · 2020: 12 · 2019: 9 · 2018: 4 · 2017: 1
- FWCI
- 7.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- American Journal of Perinatology Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Association of Women's Health, Obstetric and Neonatal Nurses
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Social Sciences › Arts and Humanities › History › Medical History and Innovations
- Keywords
- cesarean section, blood loss measurement, gravimetric measurement, visual estimation, surgical sponges, measurement agreement, obstetric hemorrhage
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