Methods
A prospective cohort study was carried out from February 2020 to March
2021 in which were included pregnant women with postpartum haemorrhage
(≥500ml in labour or ≥1000ml in c-section, Institutional definition of
postpartum haemorrhage) in a reference hospital in San Luis Potosi
Mexico (Hospital Central Dr. Ignacio Morones Prieto). The study obtained
approval from the Institutional Ethical Committee (Registration number
93-19)
We included Pregnant patients in labour or cesarean section with
postpartum haemorrhage, without conditions that might elevate lactate
concentration such as eclampsia, leukaemia, lymphoma, and solid tumours,
poorly controlled diabetes, liver failure, and ingestion of
antiretroviral drugs and biguanides, confirmed sepsis or diagnosed with
severe shock or documented anaemia at the beginning of the study,
Patients who decided to withdraw their consent or to leave the study
were eliminated. Bleeding volume was calculated by the gravimetric
method as described here, blood-Stained Surgical Gauzes from delivery or
c-section were weighed, and its dry weight was subtracted from the total
blood-stained weight. Blood weight (g) was converted into blood volume
(ml) using the accepted approximation of blood density of 1 g = 1mL. At
the diagnosis of postpartum haemorrhage (≥500ml in labour or ≥1000ml in
c-section, Institutional definition of postpartum haemorrhage),
Capillary lactate and haemoglobin were determined by bedside equipment
Acutrend plus©, and Shock index was
calculated as the heart rate (HR) divided by systolic blood pressure
(SBP). These parameters were also measured at 15 and 30 minutes after
the diagnosis.