Interpretation
What is the purpose of defining obstetric hemorrhage? The primary goals
are: 1) to establish a sensitive blood loss threshold that
triggers heightened clinical vigilance and 2) to establish aspecific indicator of severe perinatal morbidity and mortality.
Perhaps a QBL of 1000mL still functions well as a threshold that answers
to the first goal; it is sensitive and inclusive, and triggers
heightened clinical vigilance and the consideration of uterotonics or
other interventions. At 1500 QBL, however, the incidence of OBH-M is up
to 7%, which is over three times the incidence of morbidity in the
cohort at large and thus a more specific indicator for a severe
morbidity event. Establishing a tiered threshold of and a corresponding
staged response to obstetric hemorrhage may be a place to start in
decreasing risk of and having accurate indicators for severe maternal
morbidities. Using QBL of 1500cc may also be a helpful criterion to use
in future research studies regarding OBH prevention and treatment.