Other Immediate Postpartum Hemorrhage, With Delivery Clinical Trial
Official title:
The Correlation Between Inferior Vena Caval Diameter and the Volume of Postpartum Blood Loss
Excessive bleeding after normal birth or cesarean section is defined as blood loss of 1000 mL
or more (clinically estimated) within 24 hours after birth. It occurs in about 5% among
postpartum women. Postpartum hemorrhage is a leading cause of morbidity and mortality among
women giving birth. Postpartum hemorrhage may lead to hemorrhagic shock, renal failure,
respiratory failure, need for surgical intervention, blood transfusion and hysterectomy.
The cornerstone of effective treatment is rapid diagnosis and intervention in time. However,
in a number of cases there is an underestimation of the volume of blood loss which may lead
to delay in diagnosis and treatment. The consequences are even graver in women who delivered
by a cesarean section, since unlike a normal birth in which the bleeding is external and
visible, the bleeding is usually intra-abdominal, and so the delay in diagnosis may be even
longer.
The Inferior Vena Cava (IVC) is a flexible blood vessel sensitive to intravascular blood
volume, and its diameter varies accordingly. Its diameter reflects the pressure in the right
atrium, which is a measure of the cardiac preload. A number of studies have shown that the
IVC diameter changes, before the variations in vital and clinical signs.
Recently, IVC diameter has been assessed as an assessment of intravenous fluid balance in
hemodynamically stable patients with a risk of sub-volume shock. The authors concluded that
the IVC measurement is a good noninvasive method, compared to catheter insertion into the
right atrium, and it is available as a bedside procedure.
In obstetrics the use of IVC to determine blood loos was not widely examined and there is no
information regarding the use of IVC diameter as a predictor or as a detection method of
postpartum bleeding.
In this study the investigators aim to examine the correlation between IVC diameter and the
volume of postpartum blood loss.
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