Diagnostic Performance of Serial bedside Capillary Lactate, Hemoglobin, and Shock Index for Severe Postpartum  

作　　者：Roberto Arturo Castillo-Reyther Idelia Natalie Plata-Alcocer Salvador De la Maza-Labastida Venance Basil Kway Ma. del Pilar Fonseca-Leal Roberto Arturo Castillo-Reyther;Idelia Natalie Plata-Alcocer;Salvador De la Maza-Labastida;Venance Basil Kway;Ma. del Pilar Fonseca-Leal(Department of Obstetrics and Gynecology, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico;Research and Clinical Postgraduate Department of the Faculty of Medicine, Universidad Autonoma, de San Luis Potosi, Mexico)

机构地区：[1]Department of Obstetrics and Gynecology, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico [2]Research and Clinical Postgraduate Department of the Faculty of Medicine, Universidad Autonoma, de San Luis Potosi, Mexico

出　　处：《Advances in Reproductive Sciences》2021年第4期189-198,共10页生殖科学（英文）

摘　　要：<strong>Objective:</strong> <span style="white-space:normal;font-family:;" "="">To assess the diagnostic capacity of bedside capillary lactate (CLact), capillary Haemoglobin (CHb), and shock index (SI) for severe postpartum haemorrhage (SPPH > 2000 ml) at diagnosis, 15 minutes and 30 minutes later. <b>Method:</b> A cohort study was carried out in a reference hospital in San Luis Potosi, Mexico from February 2020 to March 2021, and included sixty women in vaginal labor or c-section who presented PPH (≥500 ml in labor or ≥1000 ml in c-section) measured by the gravimetric method. CLact, SI, and CHb concentrations were analyzed at diagnosis of PPH, 15 minutes, and 30 minutes. Patients who presented total blood loss of >2000 ml were considered SPPH. A T-test or Wilcox test was performed to compare the groups of non-severe and severe. Sensitivity, specificity, and performance were calculated by A Receiver Operating Curve. <b>Results:</b> A CLact measurement at 30 minutes was significantly different between the non-severe and severe groups (4.0 + 1.9 vs 4.8 + 1.15 P-value 0.001, with an optimal cut point of 4.3 mmol/dl at AUC 0.75, sensitivity 0.85, and specificity of 0.62. With a cut-point of 1.17, an AUC of 0.76, sensitivity of 0.43, and specificity of 0.98, SI at diagnosis was significantly different between the non-severe and severe groups (0.70 + 0.20 vs</span><span style="white-space:normal;font-family:;" "="">.</span><span style="white-space:normal;font-family:;" "=""> 0.90 + 0.38 P-value 0.0228). <b>Conclusion:</b> SI is an early sign of SPPH;CLact can significantly identify SPPH after 30 minutes.</span><strong>Objective:</strong> <span style="white-space:normal;font-family:;" "="">To assess the diagnostic capacity of bedside capillary lactate (CLact), capillary Haemoglobin (CHb), and shock index (SI) for severe postpartum haemorrhage (SPPH > 2000 ml) at diagnosis, 15 minutes and 30 minutes later. <b>Method:</b> A cohort study was carried out in a reference hospital in San Luis Potosi, Mexico from February 2020 to March 2021, and included sixty women in vaginal labor or c-section who presented PPH (≥500 ml in labor or ≥1000 ml in c-section) measured by the gravimetric method. CLact, SI, and CHb concentrations were analyzed at diagnosis of PPH, 15 minutes, and 30 minutes. Patients who presented total blood loss of >2000 ml were considered SPPH. A T-test or Wilcox test was performed to compare the groups of non-severe and severe. Sensitivity, specificity, and performance were calculated by A Receiver Operating Curve. <b>Results:</b> A CLact measurement at 30 minutes was significantly different between the non-severe and severe groups (4.0 + 1.9 vs 4.8 + 1.15 P-value 0.001, with an optimal cut point of 4.3 mmol/dl at AUC 0.75, sensitivity 0.85, and specificity of 0.62. With a cut-point of 1.17, an AUC of 0.76, sensitivity of 0.43, and specificity of 0.98, SI at diagnosis was significantly different between the non-severe and severe groups (0.70 + 0.20 vs</span><span style="white-space:normal;font-family:;" "="">.</span><span style="white-space:normal;font-family:;" "=""> 0.90 + 0.38 P-value 0.0228). <b>Conclusion:</b> SI is an early sign of SPPH;CLact can significantly identify SPPH after 30 minutes.</span>

关 键 词：CAPILLARY HAEMOGLOBIN LACTATE Obstetric Haemorrhage Shock Index 

分 类 号：R65[医药卫生—外科学]