A Longitudinal Study of Intraoperative Blood Loss Estimation Methods and Postpartum Anaemia Following Caesarean Delivery in Dakar, Senegal
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2020
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| author | Ndiaye, Moussa Diallo, Idrissa Diop, Aminata Sarr, Fatou |
| author_facet | Ndiaye, Moussa Diallo, Idrissa Diop, Aminata Sarr, Fatou |
| contents | <p>**Abstract** Accurate quantification of blood loss during caesarean delivery is essential for the timely management of postpartum haemorrhage and the prevention of postpartum anaemia, a leading cause of maternal morbidity in sub-Saharan Africa. In low-resource settings, clinical reliance on visual estimation persists despite its documented inaccuracy. This prospective cohort study aimed to evaluate the correlation between intraoperative blood loss estimation methods and the incidence of postpartum anaemia following caesarean delivery at a tertiary hospital in Dakar, Senegal. We enrolled 320 women undergoing elective or emergency caesarean delivery. Intraoperative blood loss was measured directly via a combined gravimetric and photometric technique (analysing surgical sponges and suction fluid) and compared with contemporaneous visual estimates by the obstetric team. Haemoglobin concentration was measured preoperatively and on postoperative day three, with anaemia defined as Hb < 110 g/L. Statistical analysis employed Spearman's correlation, Bland-Altman analysis, and multivariate regression. Direct measurement revealed a median blood loss of 450 ml (IQR 300-650). Visual estimation significantly underestimated this loss by a median of 150 ml (p<0.001), showing poor correlation (r=0.42). Postpartum anaemia incidence was 58%. Notably, visual estimation failed to identify 43% of women who developed moderate-to-severe postoperative anaemia (Hb < 90 g/L). The adjusted odds of anaemia were significantly higher when clinical management relied on visual estimation alone. Routine visual estimation is inherently inaccurate, leading to the under-recognition of substantial blood loss and associated postpartum anaemia. Implementing standardised, low-cost direct measurement techniques could improve clinical assessment and patient outcomes in resource-constrained settings. **Keywords:** Postpartum anaemia, caesarean section, blood loss estimation, maternal health, Senegal, visual estimation, gravimetric method.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_18526850 |
| institution | Zenodo |
| language | eng |
| publishDate | 2020 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | A Longitudinal Study of Intraoperative Blood Loss Estimation Methods and Postpartum Anaemia Following Caesarean Delivery in Dakar, Senegal Ndiaye, Moussa Diallo, Idrissa Diop, Aminata Sarr, Fatou Caesarean delivery Postpartum anaemia Intraoperative blood loss Sub-Saharan Africa Maternal morbidity Longitudinal cohort study <p>**Abstract** Accurate quantification of blood loss during caesarean delivery is essential for the timely management of postpartum haemorrhage and the prevention of postpartum anaemia, a leading cause of maternal morbidity in sub-Saharan Africa. In low-resource settings, clinical reliance on visual estimation persists despite its documented inaccuracy. This prospective cohort study aimed to evaluate the correlation between intraoperative blood loss estimation methods and the incidence of postpartum anaemia following caesarean delivery at a tertiary hospital in Dakar, Senegal. We enrolled 320 women undergoing elective or emergency caesarean delivery. Intraoperative blood loss was measured directly via a combined gravimetric and photometric technique (analysing surgical sponges and suction fluid) and compared with contemporaneous visual estimates by the obstetric team. Haemoglobin concentration was measured preoperatively and on postoperative day three, with anaemia defined as Hb < 110 g/L. Statistical analysis employed Spearman's correlation, Bland-Altman analysis, and multivariate regression. Direct measurement revealed a median blood loss of 450 ml (IQR 300-650). Visual estimation significantly underestimated this loss by a median of 150 ml (p<0.001), showing poor correlation (r=0.42). Postpartum anaemia incidence was 58%. Notably, visual estimation failed to identify 43% of women who developed moderate-to-severe postoperative anaemia (Hb < 90 g/L). The adjusted odds of anaemia were significantly higher when clinical management relied on visual estimation alone. Routine visual estimation is inherently inaccurate, leading to the under-recognition of substantial blood loss and associated postpartum anaemia. Implementing standardised, low-cost direct measurement techniques could improve clinical assessment and patient outcomes in resource-constrained settings. **Keywords:** Postpartum anaemia, caesarean section, blood loss estimation, maternal health, Senegal, visual estimation, gravimetric method.</p> |
| title | A Longitudinal Study of Intraoperative Blood Loss Estimation Methods and Postpartum Anaemia Following Caesarean Delivery in Dakar, Senegal |
| topic | Caesarean delivery Postpartum anaemia Intraoperative blood loss Sub-Saharan Africa Maternal morbidity Longitudinal cohort study |
| url | https://doi.org/10.5281/zenodo.18526850 |