Time of Postpartum Hemoglobin Assessment and Blood Loss During Delivery

Study Overview
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Brief Summary
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This is a prospective cohort study of patients delivering at Columbia University Medical Center/ Allen Hospital. For the primary research question, the investigators will compare the change in maternal hemoglobin from postpartum day 1 to day 2 and also determine correlation with estimation of blood loss (EBL) and quantitative blood loss (QBL).

Detailed Description
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Postpartum hemorrhage is a leading cause of maternal mortality and morbidity worldwide. Early intervention is dependent on care providers ability to accurately estimate ongoing blood loss. Studies in the past have shown that obstetricians and midwives tend to overestimate blood loss when the lost volumes are small while tend to underestimate by as much as 40 to 50 percent when a large volume of blood is lost. Multiple studies have shown that routine hemoglobin assessment in postpartum patients after uneventful delivery either vaginal or via cesarean section, is not necessary. This leads to increased cost of care without any added benefit and causes inconvenience to the patients. However knowing how imprecise blood loss estimation can be it is reasonable to screen women for anemia prior to discharge.

Official Title
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Optimal Time for Postpartum Hemoglobin Assessment and Its Correlation With Estimated Blood Loss (EBL)/Quantitative Blood Loss (QBL)

Conditions
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Hemorrhage, Postpartum

Intervention / Treatment
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* Procedure: Blood Draw


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All antepartum patients receiving prenatal care at the Broadway Practice and plan to deliver at Allen Hospital in NYC. Exclusion Criteria: Patients who gave consent to participate in the study but did not deliver at Allen hospital.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Antepartum Patients<br>Includes antepartum patients receiving prenatal care at the Broadway Practice who plan to deliver at Allen Hospital in New York City (NYC). On postpartum day 1 and day 2, a sample of blood will be drawn in the morning for hemoglobin and hematocrit estimation. | Procedure: Blood Draw<br>* On postpartum day 1 and day 2, a sample of blood will be drawn in the morning for hemoglobin and hematocrit estimation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in maternal hemoglobin | Maternal hemoglobin will be measured on postpartum day 1 to day 2 | Day 1 and Day 2 | 
| Correlation of maternal hemoglobin to EBL | Maternal hemoglobin will be measured to assess correlation to visually estimated blood loss | Up to 2 days after delivery | 
| Correlation of maternal hemoglobin to QBL | Maternal hemoglobin will be measured to assess correlation to quantified blood loss | Up to 2 days after delivery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postpartum, Hemoglobin