Accuracy of Blood Loss Estimation and Measurement at Cesarean Birth

Abstract

This prospective study on 100 women undergoing cesarean delivery was undertaken to evaluate the accuracy of the operating surgeon in estimating the amount of blood loss at the time of surgery. Exclusion factors were bleeding diathesis and cesarean hysterectomy. Blood loss was calculated by direct suction apparatus measurement and by weighing (before/after) lap pads, sponges, and drapes. The operating surgeon (second or third postgraduate year) estimated the blood loss at operation. These results were compared with the calculated blood amount. Estimation within ± 100 mL of the actual blood loss was considered correct. The obstetric resident estimated blood loss correctly less than 50% of the time. When the calculated loss of blood was <800 cc, residents tend to overestimate the blood loss, whereas if it was >800 cc, underestimation was more likely. In this study, obstetric surgeons estimated the blood loss at cesarean section incorrectly in more than half the cases. A simple, more accurate technique of documenting operative blood loss is available.

Key Words:

• Blood loss
• Accuracy
• Cesarean