Can measuring blood loss at delivery reduce hemorrhage-related morbidity?

Quantitation of blood loss after vaginal and cesarean delivery has been advocated for the timely detection of postpartum hemorrhage and activation of protocols for resuscitation. Morbidity and mortality from postpartum hemorrhage is considered to be largely preventable and is attributed to delayed recognition with under-resuscitation or inappropriate resuscitation. Optimizing detection of postpartum hemorrhage through refining how blood loss is measured is therefore clinically relevant. In this review on quantitative blood loss for postpartum hemorrhage, recent advances in the methods used to quantitate blood loss will be reviewed, with a comparison of utility and precision for blood loss measurement after vaginal and cesarean delivery. Considerations for the implementation of a quantitative blood loss system on the labor and delivery unit, including its benefits and challenges, will be discussed. The existing evidence for impact of blood loss quantitation in obstetrics on hemorrhage-related morbidity will be delineated, along with knowledge gaps and future research priorities.