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It is important to recognize excessive blood loss during childbirth, which is a signiï¬cant cause of morbidity and mortality. This article reviews methods to measure blood loss that could be used during childbirth. PubMed, CINAHL, and MEDLINE databases were searched using the phrases ââblood lossââ and ââmeasurement.ââ The bibliographies of publications were scanned for applicable references. A total of 46 publications are included in this review. The methods used to measure blood loss are categorized into visual estimation, direct measurement, gravimetric, photometry, and miscellaneous. Methods are described and compared. A combination of direct measurement and gravimetric methods are the most practical. Photometry is the most precise, but also the most expensive and complex to use. A variety of miscellaneous methods are presented, but none is a practical or reliable method. Visual estimation of blood loss is so inaccurate that its continued use in practice is questionable and it should not be used in research to evaluate treatment. J Midwifery Womens Health 2010;55:20â27 Ã 2010 by the American College of Nurse-Midwives.
A concrete and useful way to create an action plan for improving the quality of maternity care in the United States is to start with a view of the desired result, a common definition and a shared vision for a high-quality, high-value maternity care system. In this paper, we present a long-term vision for the future of maternity care in the United States.We present overarching values and principles and specific attributes of a high-performing maternity care system. We put forth the "2020 Vision for a High-Quality, High-Value Maternity Care System" to serve as a positive starting place for a fruitful collaborative process to develop specific action steps for broad-based maternity care system improvement.
OBJECTIVE: The objective of the study was to characterize severe illness because of the 2009 pandemic influenza A (H1N1) infection in postpartum women.
STUDY DESIGN: We reviewed case reports of infected hospitalized postpartum (6 months from delivery) women identified through statewide surveillance in California. From April 23 through August 11, 2009, all hospitalizations and/or deaths were reported. After August 11, reporting was limited to cases requiring intensive care or deaths.
RESULTS: From April 23 to December 31, 2009, 15 cases were reported; 11 (73%) had symptom onset within 7 days postpartum. Of 10 hospitalized cases reported through August 11, 4 required intensive care, 3 required mechanical ventilation, and 2 died. Of 5 cases requiring intensive care reported after August 11, all required mechanical ventilation and 1 died. Overall, 6 (43%) received antivirals
within 48 hours of symptom onset.
CONCLUSION: The 2009 H1N1 can cause severe illness in postpartum women, especially in the first week following delivery.