The utility of shock index and heart rate in the management of postpartum blood loss in pregnant women complicated with hypertensive disorders in pregnancy.
BACKGROUND
Although the shock index (SI) (heart rate/systolic blood pressure) and heart rate (HR) are a helpful indicator in the management of postpartum blood loss, there are few reports of SI in pregnant women complicated with hypertensive disorders in pregnancy (HDP). The purpose of this study was to examine whether SI and HR would be a clinically helpful indicator, and to detect the cutoff value for judging abnormal obstetric bleeding.


METHODS
This was a retrospective case-control study in 107 patients with HDP in a singleton tertiary perinatal medical facility. The values of postpartum highest SI (peak SI) and highest HR (peak HR), and the amount of bleeding until peak SI and peak HR were retrospectively examined and analyzed. We used the receiver operating characteristic analysis to assess the diagnostic value of peak SI and peak HR for judging abnormal obstetric bleeding.


RESULTS
Peak SI and peak HR were significantly related to the amount of bleeding up to peak SI and up to peak HR. The cutoff values of peak SI with blood loss volumes above 500 ml, 1000 ml, and 1500 ml were 0.77, 0.76, and 0.99, respectively. The cutoff values of peak HR with blood loss volumes above 500 ml, 1000 ml, and 1500 ml were 97, 98, and 103, respectively.


CONCLUSION
In cases of pregnant women complicated with HDP, both SI and HR were probably useful indicators in the management of postpartum blood loss. Further prospective trials are warranted to confirm these results.
['Mori|Hiroshi|H|', 'Shibata|Eiji|E|', 'Kuwazuru|Tomoichiro|T|', 'Uchimura|Takayuki|T|', 'Kondo|Emi|E|', 'Yoshino|Kiyoshi|K|']
D016022:Case-Control Studies D005260:Female D006339:Heart Rate D006801:Humans D046110:Hypertension, Pregnancy-Induced D049590:Postpartum Period D011247:Pregnancy D037841:Pregnant Women D012189:Retrospective Studies
critical care obstetrics postpartum care postpartum hemorrhage preeclampsia/eclampsia