PLD.37 Shock Index (SI) as a Predictor of Adverse Outcome in Women with Post Partum Haemorrhage (PPH). (9th June 2014) - Nathan, HL
Abstract : Introduction: Early recognition of haemodynamic instability following PPH is necessary to instigate interventions to prevent maternal morbidity and mortality. Conventional markers of haemodynamic compromise are relatively insensitive. Objectives: To evaluate SI, the ratio of heart rate (HR) to systolic blood pressure (SBP), as a predictor of adverse clinical outcome following PPH, compared to SBP, diastolic blood pressure (DBP), HR, mean arterial pressure (MAP) and pulse pressure (PP). Methods: A retrospective study of women with PPH of 1500ml or more at a large tertiary referral centre over a one-year period (n = 233). SBP, DBP, and HR were collected within the first hour following PPH recognition and SI, MAP, and PP were calculated. Adverse outcomes included haemoglobin level <7 g/dL, blood transfusion ≥ 4 units and admission to ICU. Results: Area under the ROC curve of each predictor (95% confidence interval). Conclusion: SI was superior to standard vital signs and may be a useful predictor of adverse clinical outcome in women with PPH. SI could easily be incorporated into early warning algorithms in postpartum care.