Determining the Amount of Blood Loss in Cases of Obstetric Hemorrhage

Literature Review

Authors

  • I Gde Sastra Winata Department of Obstetrics and Gynecology, Prof. Dr. I.G.N.G. Ngoerah General Hospital/Faculty of Medicine, Udayana University, Denpasar
  • Leonardo Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
  • Gita Sirini Candijaya Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
  • Erlin Purnama Muliawan Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • I Gede Bayu Adi Pratama Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • Bagus Andika Pramana Faculty of Medicine, Udayana University, Denpasar, Indonesia

DOI:

https://doi.org/10.55175/cdk.v52i12.1692

Keywords:

Blood loss, blood loss quantification methods, visual methods, obstetric hemorrhage

Abstract

Postpartum hemorrhage is a leading cause of maternal death worldwide and remains a serious health concern, particularly in developing countries such as Indonesia. Accurate estimation of blood loss is essential for early detection of emergencies and for implementing rapid and appropriate interventions for patients. This review discusses several methods used to determine the amount
of blood loss in obstetric cases, including visual estimation, quantitative measurement, and laboratory evaluation. The visual method is easily applied in primary health facilities but frequently underestimates blood loss due to lighting, fluid mixtures, and the experience of health providers. Quantitative methods, such as weighing blood-soaked materials or collecting blood in calibrated containers, are considered more objective and accurate. Laboratory assessment through hemoglobin concentration, hematocrit levels, and spectrophotometric analysis provides confirmation of clinical estimates. Combining quantitative and laboratory approaches can improve diagnostic accuracy, expedite clinical management, and ultimately reduce maternal morbidity and mortality associated with obstetric hemorrhage.

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References

Diaz V, Abalos E, Carroli G. Methods for blood loss estimation after vaginal birth. Cochrane Database Syst Rev. 2018 Sep

;9(9):CD010980. doi: 10.1002/14651858.CD010980.pub2.

Agar Ibu dan Bayi Selamat - Sehat Negeriku [Internet]. [cited 2024 Dec 9]. https://sehatnegeriku.kemkes.go.id/baca/

blog/20240125/3944849/agar-ibu-dan-bayi-selamat/.

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia tahun 2019 [Internet]. Jakarta: Kementerian Kesehatan;

Available from: https://kemkes.go.id/id/profil-kesehatan-indonesia-2019.

Winata IGS, Suardika A, Mahayasa PD, Budiana NG, Kamajaya IGNA. Role of hypogastric artery ligation in obstetric and gynecological

hemorrhage: narrative review. Indonesian Journal of Perinatology (Perinasia) 2024;5(2):42−5. https://doi.org/10.51559/inajperinatol.

v5i2.59.

Andrikopoulou M, D’Alton ME. Postpartum hemorrhage: early identification challenges. Semin Perinatol. 2019;43(1):11–7. doi: 10.1053/j.semperi.2018.11.003.

Bose P, Regan F, Paterson-Brown S. Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical

reconstructions. BJOG. 2006;113(8):919–24. doi: 10.1111/j.1471-0528.2006.01018.x.

Patel A, Goudar SS, Geller SE, Kodkany BS, Edlavitch SA, Wagh K, et al. Drape estimation vs. visual assessment for estimating

postpartum hemorrhage. Int J Gynaecol Obstet. 2006;93(3):220–4. doi: 10.1016/j.ijgo.2006.02.014.

Dildy GA, Paine AR, George NC, Velasco C. Estimating blood loss: can teaching significantly improve visual estimation? Obstetrics

and gynecology. 2004;104(3):601–6. doi: 10.1097/01.AOG.0000137873.07820.34.

Toledo P, McCarthy RJ, Hewlett BJ, Fitzgerald PC, Wong CA. The accuracy of blood loss estimation after simulated vaginal delivery.

Anesth Analg. 2007;105(6):1736–40. doi: 10.1213/01.ane.0000286233.48111.d8.

Al Kadri HMF, Al Anazi BK, Tamim HM. Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective

cohort study. Arch Gynecol Obstet. 2011;283(6):1207–13. doi: 10.1007/s00404-010-1522-1.

Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine PL, et al. National partnership for maternal safety: consensus bundle on obstetric hemorrhage. JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing 2015;44(4):462–70. doi: 10.1097/

AOG.0000000000000869.

Quantification of blood loss: AWHONN practice brief number 1. J Obstet Gynecol Neonatal Nurs. 2015;44(1):158–60. doi: 10.1111/1552-6909.12519.

Algadiem EA, Aleisa AA, Alsubaie HI, Buhlaiqah NR, Algadeeb JB, Alsneini HA. Blood loss estimation using gauze visual analogue.

Trauma Mon. 2016;21(2):e34131. doi: 10.5812/traumamon.34131.

Zhang WH, Deneux-Tharaux C, Brocklehurst P, Juszczak E, Joslin M, Alexander S. Effect of a collector bag for measurement of

postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries. BMJ. 2010;340(7741):301. doi: 10.1136/

bmj.c293.

Billett HH, Walker HK, Hall WD, Hurst JW. Hemoglobin and hematocrit. Anesthesiology [Internet]. 1990 [cited 2024 Dec 9]. Available

from: https://www.ncbi.nlm.nih.gov/books/NBK259/. PMID: 21250102.

Gupta A, Wrench IJ, Feast MJ, Alderson JD. Use of the HemoCue near patient testing device to measure the concentration of

haemoglobin in suction fluid at elective caesarean section. Anaesthesia 2008;63(5):531–4. doi: 10.1111/j.1365-2044.2007.05400.x.

Mondal H, Zubair M. Hematocrit [Internet]. 2024 [cited 2024 Dec 9]. Available from: https://www.ncbi.nlm.nih.gov/books/

NBK542276/. PMID: 31194416.

Lopez-Santiago N. Coagulation tests. Acta Pediatrica de Mexico. 1990;37(4):241–5. https://doi.org/10.18233/APM37No4pp241-245.

Castro D, Patil SM, Zubair M, Keenaghan M. Arterial blood gas [Internet]. 2024 [cited 2024 Dec 9]. Available from: https://www.ncbi.

nlm.nih.gov/books/NBK536919/. PMID: 30725604.

Published

05-12-2025

How to Cite

Winata, I. G. S., ., L., Candijaya, G. S., Muliawan, E. P., Pratama, I. G. B. A., & Pramana, B. A. (2025). Determining the Amount of Blood Loss in Cases of Obstetric Hemorrhage: Literature Review. Cermin Dunia Kedokteran, 52(12), 829–833. https://doi.org/10.55175/cdk.v52i12.1692