Hemodynamic variables of obstetric hemorrhagic shock and their relationship with massive transfusión
Keywords:
SHOCK; HEMORRAGIA; OBSTÉTRICA; TRANSFUSIÓN., SHOCK; HEMORRHAGE; OBSTETRICS; TRANSFUSION., SHOCK; HEMORRAGIA; OBSTETRÍCIA; TRANSFUSÃO.Abstract
Introduction: severe obstetric hemorrhage is the leading cause of preventable pregnancy-related death worldwide.
Objective: to demonstrate the relationship between hemodynamic variables of obstetric hemorrhagic shock and massive transfusion in patients admitted to Intensive Care Unit 3 of the General Teaching Hospital “Abel Santamaría Cuadrado,” from January 2020 to March 2024. Methods: a descriptive, retrospective, longitudinal, cross-sectional study was conducted in mothers with obstetric hemorrhagic shock. Data were obtained from medical records; the universe consisted of 125 mothers with obstetric hemorrhage. The sample included 58 with severe obstetric hemorrhagic shock. Statistical processing used absolute and relative frequency, chi-square, and mean.
Results: severe obstetric hemorrhage was more frequent in cesarean deliveries (51,73 %), with uterine atony predominating (41,38 %). In the ICU, length of stay was less than five days (81,03 %). At admission, the most representative macrocirculatory variable was the shock index (1,85 ± 0,5), and in microcirculation, the base deficit (-16 ± 4). High statistical significance (p <0.001) was found for pH, base deficit, central venous oxygen saturation, and delta PCO2 in predicting the use of massive transfusion, as well as the shock index, which showed greater predictive value than cardiac output. Cardiac output decreased and systemic vascular resistance increased in relation to the magnitude of bleeding.
Conclusions: knowledge and management of microcirculatory variables and the shock index correlate with the use of massive transfusion in severe obstetric hemorrhage.
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