Stardard reference values in the fourth period of labour

Abstract

Introduction: Hemorrhage is the leading cause of maternal death worldwide, and elevation in shock index (SI) has been associated with severe maternal outcomes due to postpartum hemorrhage (PPH). However, there are no expected reference values in the literature for the SI in the puerperium. Objectives: To determine the Shock Index reference intervals in the first two hours of the puerperium in women without comorbidities, as well as to evaluate whether maternal age, Body Mass Index and peripartum analgesia interfere with these values. Methods: A secondary analysis of data collected in a prospective cohort study will be performed, with 270 women recruited during labor and followed up to 24 hours after delivery. The study population consisted of pregnant women of any age, admitted in labor, with single pregnancies of live fetuses, with a gestational age greater than 34 weeks. Immediately after the delivery, a sterile blood collector with calibrated receptacle was placed under the patient's buttocks. Blood loss was assessed objectively by summing the blood amount present in the collector to the blood contents present in pads, absorbents and diapers, when used. The exploratory data analysis will be performed to evaluate the mean, standard deviation, minimum and maximum values, median, frequency, percentage and percentiles. Statistical differences will be calculated with the non-parametric Mann-Whitney test. A linear multiple regression will then be performed and, finally, the data will be analyzed corrected for body mass index, analgesia and age. (AU)