(266) The association between post-delivery inferior vena cava diameter and Postpartum hemoglobin levels

Inferior vena cava (IVC) diameter has been suggested as a useful sonographic tool for estimation of blood loss. To this date, it has been investigated only in an acute or massive hemorrhage setting. The aim of the present study was to determine whether IVC diameter can be an effective prognostic tool for predicting postpartum hemoglobin (Hb) level drop 24-48 hours after delivery.

Study Design: A single center prospective cohort study, included postpartum women who delivered at 37 to 41 weeks of gestation. Cesarean delivery, multiple pregnancies, Patients with known coagulation disorders or hepatic failure and those using anticoagulation drugs were excluded from the study. Abdominal ultrasonography measurements were performed 24-48 hours after delivery, Hb levels were taken before delivery and 24-48 hours after delivery to assess blood loss. Delta-IVC was defined as the difference between IVC diameter at expirium (IVCe) and at inspirium (IVCi). Spearman correlation test was used to assess for correlation between Hb levels and IVC diameter. Man-Whitney's U test was used to compare IVC diameters in cases with Hb drop of above 2g gr\dl and below.

Results:

We found no significant correlation between Hb levels and IVCi, IVCe or delta-IVC. Moreover, there was no difference in IVC diameters between parturients with a Hb drop of more than 2 gr/dl and those with a Hb drop of less than 2 gr/dl

Conclusion:

Our findings did not show a significant association between IVC diameters and Hb levels. This may indicate that IVC diameter measurement, though useful in an acute setting, is not suitable for follow-up in stable patients.