51. The utility of shock index and heart rate in the management of postpartum blood loss in pregnant women complicated with hypertensive disorders in pregnancy
- Author
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Kiyoshi Yoshino, Emi Kondo, Takayuki Uchimura, Tomoichiro Kuwazuru, Eiji Shibata, and Hiroshi Mori
- Subjects
medicine.medical_specialty ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,Heart Rate ,Pregnancy ,Internal medicine ,Heart rate ,medicine ,Humans ,Cutoff ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Receiver operating characteristic analysis ,business.industry ,Postpartum Period ,Obstetrics and Gynecology ,Postpartum care ,Hypertension, Pregnancy-Induced ,medicine.disease ,Shock index ,Blood pressure ,Case-Control Studies ,030220 oncology & carcinogenesis ,Cardiology ,Female ,Pregnant Women ,business - Abstract
Background Although the shock index (SI) (heart rate/systolic blood pressure) and heart rate (HR) are a helpful indicator in the management of postpartum blood loss, there are few reports of SI in pregnant women complicated with hypertensive disorders in pregnancy (HDP). The purpose of this study was to examine whether SI and HR would be a clinically helpful indicator, and to detect the cutoff value for judging abnormal obstetric bleeding. Methods This was a retrospective case-control study in 107 patients with HDP in a singleton tertiary perinatal medical facility. The values of postpartum highest SI (peak SI) and highest HR (peak HR), and the amount of bleeding until peak SI and peak HR were retrospectively examined and analyzed. We used the receiver operating characteristic analysis to assess the diagnostic value of peak SI and peak HR for judging abnormal obstetric bleeding. Results Peak SI and peak HR were significantly related to the amount of bleeding up to peak SI and up to peak HR. The cutoff values of peak SI with blood loss volumes above 500 ml, 1000 ml, and 1500 ml were 0.77, 0.76, and 0.99, respectively. The cutoff values of peak HR with blood loss volumes above 500 ml, 1000 ml, and 1500 ml were 97, 98, and 103, respectively. Conclusion In cases of pregnant women complicated with HDP, both SI and HR were probably useful indicators in the management of postpartum blood loss. Further prospective trials are warranted to confirm these results.
- Published
- 2021