Use of histograms to assess the efficacy of uterotonic treatment for post-partum haemorrhage: A feasibility study

Publication date: Available online 21 May 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Nasreen B. Aflaifel, Nomita Chandhiok, Bukola Fawole, Stacie E. Geller, Andrew D. WeeksAbstractPost-partum haemorrhage (PPH) is a major pathological condition leading to mortality of women worldwide. Its initial treatment has largely been focused on uterotonics. This paper examines the use of histograms to assess the efficacy of uterotonic treatment for PPH. Previous examinations of large datasets in which women were treated at 700 ml of measured blood loss according to strict protocols have shown a quantifiable peak in the histogram at 700–800 ml following treatment. It is not clear whether this is commonly seen in other studies. The main aim was therefore to assess whether post-treatment peaks are routinely seen in postpartum blood loss histograms and whether the peaks are seen only in treated women. Four datasets of more than 1000 women with measured blood loss were identified and the original data examined. The secondary peak was seen in not only histograms attributed to treated cases but also many of the histograms attributed to many women who did not receive uterotonic treatment. Many women received treatment despite having blood loss of less than 500 ml, and many women who stopped bleeding with final blood losses of more than 500 ml did not receive any uterotonics. The routine use of histogram analysis to assess the efficiency of uterotonic t...

Source: Best Practice and Research Clinical Obstetrics and Gynaecology - June 8, 2019 Category: OBGYN Source Type: research