Thread by @OBsleepmerchant

@MariePierreBon2 kicks day 3 off with diagnosis of PPH. She reminds us the OB hemorrhage causes both mortality and severe morbidity (2/3 in France). Not to be ignored, PPH and APH precipitate majority of maternal cardiac arrest. #OBAnes “Too little, too late” kills
#OAA3dc2022

Factors associated with PPH severity, #OBAnes can impact initial care - prevent “too little too late” cycle. Delay of diagnosis is bad. HOW do we diagnose? 3T’s 3 F’s #OAA3dc2022

Graduated blood collection bags do NOT reduce rates of severe PPH. Visual aids only useful if no collection bag. Quantitative measurement may have a positive impact on outcomes. #OAA3dc2022

Colorimetric devices - ? Have promise? #OAA3dc2022

Shock index 9 or greater = 100% sensitivity, but poor specificity. Also poor correlation between maximal shock index and blood loss. Poor sensitivity for PPH > 1000mL #OAA3dc2022

Biological diagnosis better? Fibrinogen level correlates best with blood loss. Remember Hb is NOT useful. Fibrinogen level <2g/L 99% specificity, POOR sensitivity, for PPH severity. #OAA3dc2022

Fibrinogen POC is way of future, although the devices may not be there yet? More from Prof Rachel Collis later. Summary slide from @MariePierreBon2 #OAA3dc2022