Postpartum haemorrhage: minimum allowable haemoglobin level

Keywords: minimum level of haemoglobin, haematocrit, correlation, postpartum haemorrhage, systemic transport of oxygen

Abstract

Despite defining the acceptable postpartum haemoglobin levels, there is neither consensus, nor a strong statistically proven analysis of its minimum safe level and its influence on systemic haemodynamic and oxygen metabolism in particular.

The aim. Therefore, this study aimed to determine statistically minimal allowable haemoglobin levels in postpartum women in case of postpartum haemorrhage which allows the cardiac functional status and oxygen metabolism to be maintained on the lower margin of the physiological range.

Materials and methods: Clinical research was on 113 postpartum women who had received blood transfusions for postpartum haemorrhages were selected for this study. The following circulation parameters were assessed: heart rate (HR), systolic blood pressure (BPs), diastolic blood pressure (BPD), mean arterial pressure (MAP), central venous pressure (CVP), cardiac index (СІ), contractility index (ΔS), systemic vascular resistance index (SVRI), systemic oxygen delivery index (IDО2), systemic oxygen consumption index (IVО2), tissue oxygen extraction ratio (O2ER).

Results: Through a comparison of hemodynamic parameters depending on haematocrit and haemoglobin levels in patients with postpartum blood loss it was discovered that in case of blood loss and consequent intensive therapy aimed at TBV (total blood volume) restoration statistically significant changes of BPs, MAP, СІ and SVRI were observed. Also, during this study linear high-degree correlations between СІ, ΔS and Hb levels were found.

Analysis of systemic oxygen transport dependence on haematocrit and haemoglobin levels for patients during the early postpartum period demonstrates significant differences in cardiac indexes with a strong positive statistically significant correlation between these parameters and haemoglobin levels.

Conclusion. From the calculation of the minimum allowable haemoglobin level in postpartum women in case of blood loss using linear regression with coefficients calculated through the method of least squares the Hb=82.5 g/L value was obtained, which can be considered the minimum allowable level in postpartum women in case of postpartum blood loss which allows the cardiac functional status and oxygen metabolism to be on safety physiological range

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Author Biographies

Dmytro Dziuba, Shupik National Healthcare University of Ukraine

Department of Anesthesiology and Intensive Care

Oleg Loskutov, Shupik National Healthcare University of Ukraine

Department of Anesthesiology and Intensive Care

Oleksiy Khavryuchenko, Shupik National Healthcare University of Ukraine

Department of Anesthesiology and Intensive Care

Dmytro Mityurev, Lviv Regional Clinical Perinatal Center; Shupik National Healthcare University of Ukraine

Department of Anesthesiology and Intensive Care

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Postpartum haemorrhage: minimum allowable haemoglobin level

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Published
2022-07-31
How to Cite
Dziuba, D., Loskutov, O., Khavryuchenko, O., & Mityurev, D. (2022). Postpartum haemorrhage: minimum allowable haemoglobin level. EUREKA: Health Sciences, (4), 3-17. https://doi.org/10.21303/2504-5679.2022.002569
Section
Medicine and Dentistry