Early prognostic capacity of serum lactate for severe postpartum hemorrhage Article uri icon

abstract

  • Objective: To evaluate whether the concentration of serum lactate during the diagnosis of postpartum hemorrhage (bleeding ≥500 mL during labor or ≥1000 mL during cesarean delivery) predicts severe hemorrhage (SPPH; blood loss ≥1500 mL at end of labor or in the following 24 h). Methods: A prospective cohort pilot study was conducted of women with a vaginal or cesarean delivery from February 2018 to March 2019 who presented with bleeding ≥500 mL measured by the gravimetric method in a reference hospital in San Luis Potosi, Mexico. Venous blood samples were taken for analysis of serum lactate. A receiver operating characteristic curve determined the serum lactate threshold value for SPPH and χ2 test assessed the difference in serum lactate elevation between SPPH and non-SPPH groups. Lastly, the prognostic capacity between the thresholds was compared. Results: SPPH developed in 43.33%25 of the 30 women in the study group. The best prognostic threshold was 2.68 mmol/L of serum lactate (odds ratio [OR] 17.88, 95%25 confidence interval [CI] 2.7–16.8, P < 0.001); sensitivity was 0.85 (95%25 CI 0.55–0.98); specificity was 0.76 (95%25 CI 0.50–0.93). Conclusion: Serum lactate may be a useful prognostic marker for SPPH, more studies are needed to validate these findings. © 2020 International Federation of Gynecology and Obstetrics

publication date

  • 2020-01-01