Case–control study of shock index among women who did and did not receive blood transfusions due to postpartum hemorrhage

Abstract

OBJECTIVE: To compare shock index (SI) values between women who required blood transfusion due to postpartum hemorrhage (PPH) and women who did not. METHODS: In a case-control study, clinical data were assessed from the medical records of women requiring blood transfusion for PPH at a center in Brazil between 2012 and 2015 (n=105). A control group was randomly selected from women who did not receive blood transfusion (n=129). RESULTS: Compared with women who did not receive a transfusion after delivery, women who did receive one had significantly higher SI values 10 minutes after delivery (0.81 ± 0.27 vs 0.72 ± 0.16; P=0.012), at 30 minutes (0.83 ± 0.26 vs 0.71 ± 0.15; P<0.001), and at 2 hours (0.84 ± 0.27 vs 0.70 ± 0.14; P=0.032). For vaginal deliveries, SI values were significantly different at 30 minutes (0.88 ± 0.26 vs 0.71 ± 0.14; P<0.001) and 2 hours (0.90 ± 0.23 vs 0.72 ± 0.14; P=0.001). No significant differences were found for cesarean delivery. CONCLUSION: The SI might be useful to identify early vital sign changes due to PPH. Increased SI values were associated with need for transfusion in vaginal deliveries.