Clinical Experience with the Implementation of Accurate Measurement of Blood Loss during Cesarean Delivery: Influences on Hemorrhage Recognition and Allogeneic Transfusion

Objective  This article compares hemorrhage recognition and transfusion using accurate, contemporaneous blood loss measurement versus visual estimation during cesarean deliveries. Study Design  A retrospective cohort study using visually estimated blood loss (traditional, n  = 2,025) versus estimates using a mobile application that photographs sponges and canisters and calculates their hemoglobin content (device, n  = 756). Results  Blood loss > 1,000 mL was recognized in 1.9% of traditional visual estimation patients, while measured blood loss of > 1,000 mL occurred in 8.2% of device patients ( p p p  = 0.038). None of the patients in the device group received plasma or cryoprecipitate. Seven patients in the traditional group received these products ( p  = 0.088). Device use was associated with shorter hospital stays (4.0 ± 2.3 versus 4.4 ± 2.9 days; p  = 0.0006). Conclusion  The device identified hemorrhages more frequently than visual estimation. Device-detected hemorrhages appeared clinically relevant. Blood product transfusion was reduced possibly due to earlier recognition and treatment, although further studies are needed to verify the conclusion.