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Anemia diagnosis by hemoglobin level monitoring in women after vaginal delivery by symptoms versus screening of women at increased risk for post-partum anemia.
Anemia is common following delivery. It is associated with some serious complications including increased risk for syncope and in severe cases even cardiogenic shock. Yet, anemia-associated symptoms might manifest relatively late after the patient have lost a fair amount of blood, which was not diagnosed early enough. To date, there are not acceptable guidelines for monitoring hemoglobin levels after delivery. Theoretically, there are 2 approaches for hemoglobin monitoring - one by taking hemoglobin levels in order to diagnose anemia in patients reporting anemia-associated symptoms. The other approach is by screening of women at increased risk for post-partum anemia. In the present study we aimed to compare those 2 approaches.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Postpartum anemia diagnosis following symptoms | Experimental | Post partum anemia will be assessed by taking hemoglobin level following symptoms consistent with anemia, severe postpartum hemorrhage or hemoglobin level below 8 g/dL in the first 5 days following delivery |
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| Postpartum anemia diagnosis following patients screening | Experimental | Post partum anemia will be assessed by taking hemoglobin level in patients at increased risk to develop post-partum anemia in the first 5 days following delivery, defined as patients with initial (before or immediately after delivery) hemoglobin level of 10.5 g/dl or less regardless of symptoms, or in cases of severe post partum hemorrhage. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Monitoring hemoglobin levels following anemia associated symptoms | Other | Post-partum anemia will be diagnosed after vaginal delivery by taking hemoglobin levels to patients with symptoms consistent with anemia, severe postpartum hemorrhage or hemoglobin level below 8 g/dL. |
| Measure | Description | Time Frame |
|---|---|---|
| The rate of patients diagnosed with anemia | Hemoglobin of 10 g/dl or below | Up to 3 days postpartum |
| The rate of patients who received treatment with intravenous iron sucrose | Up to 3 days postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| The rate of patients who received blood transfusion | From delivery and up to 5 days | |
| The rate of women with post-partum hemorrhage | From delivery and up to 5 days | |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Haemek Medical Center | Afula | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33737646 | Derived | Yefet E, Yossef A, Nachum Z. Prediction of anemia at delivery. Sci Rep. 2021 Mar 18;11(1):6309. doi: 10.1038/s41598-021-85622-7. |
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| Monitoring hemoglobin levels to detect anemia by screening of women at increased risk for post partum anemia | Other | Post-partum anemia will be diagnosed after vaginal delivery by taking hemoglobin levels to high risk women for post-partum anemia, defined as hemoglobin levels of 10.5 g/dl or below around delivery, or severe postpartum hemorrhage with or without symptoms associated with anemia |
|
| The rate of women who underwent uterine revision following delivery after their arrival to the maternity ward |
| From delivery and up to 5 days |
| The rate of women who needed uterotonic agents after their arrival to the maternity ward | From delivery and up to 5 days |
| The average blood tests number that was performed | From delivery and up to 5 days |
| Minimal and average hemoglobin level | From delivery and up to 5 days |
| The composite symptoms of anemia and functional capacity after 6 weeks postpartum as assessed by a questionnaire | Each question in the questionnaire will receive a score. The total score will be reported. | 6 weeks postpartum |
| Hemoglobin level 6 weeks postpartum | 6 weeks postpartum |