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Created on : 03 Nov 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Hémorragies non diagnostiquées du postpartum. [Missed diagnosis of postpartum hemorrhage] J Gynecol Obstet Biol Reprod 2001; 30 : 590-600.

Author(s) :

Descargues G, Pitette P, Gravier A, Roman H, Lemoine JP, Marpeau L.

Year of publication :

2001

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

L’erreur de diagnostic s’est avérée liée au recours à une estimation visuelle de l’intensité du saignement, un indicateur très peu fiable, notamment lorsqu’on ne dispose d’aucun moyen de recueillir et mesurer les pertes sanguines. De plus, il faudrait revoir les facteurs qui ont un impact sur le développement d’une hémorragie, particulièrement pour ce qui concerne les patientes primipares.

Les hémorragies non diagnostiquées ont reçu significativement plus d’ocytocine que les hémorragies diagnostiquées au moment de l’accouchement, et celles-ci plus que la population témoin (respectivement 80, 66.4 et 54.7%).

(Etude de 5517 accouchements vaginaux en 1999. Clinique Gynecologique et Obstetricale, Hopital Charles-Nicolle, CHU Rouen)

Abstract (English)  :

OBJECTIVE: The purpose of this work was to search for the reasons why the diagnosis of post-partum hemorrhage may be missed.

PATIENTS AND METHODS: We reviewed retrospectively the files 5,517 vaginal delivery patients cared for in our Gynecology and Obstetrics Unit at the Rouen University Hospital between January 1, 1997 and September 30, 1999. Among these patients, 90 (1.63%) developed anemia during the post-partum period with a 10-point fall in the hematocrit from the pre-delivery level, which corresponds to a 1 liter loss of blood, but for whom no diagnosis of hemorrhage was made. We compared this group with the population of patients who had had a diagnosis of hemorrhage. The chi-squared or Fischer’s exact text were used where appropriate to compare means and calculate z.

RESULTS: Significant risk factors were: primiparity, anemia before delivery, labor induction, locorregional anesthesia, use of ocytocin, long labor with a long active phase, fever during labor, episiotomy and prolonged delay between delivery and onset of suture.

CONCLUSIONS: Missed diagnosis appeared to be related to use of visual assessment to determine the degree of bleeding, a very mediocre indicator, particularly when no means of blood collection or quantification is used. In addition, factors having an impact on the development of hemorrhage should be revisited with particular attention given to primiparous patients.

(Clinique Gynecologique et Obstetricale, Hopital Charles-Nicolle, CHU Rouen)

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Les hémorragies non diagnostiquées ont reçu significativement plus d’ocytocine que les hémorragies diagnostiquées au moment de l’accouchement, et celles-ci plus que la population témoin

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ postpartum hemorrhage ; oxytocin ; induction of labor ; post-term pregnancy

Author of this record :

Bernard Bel — 03 Nov 2004