Research Progress on the Application of Shock Index in Postpartum Hemorrhage

doi:10.12280/gjfckx.20230253

Abstract

Abstract:

Postpartum hemorrhage is a common serious complication in obstetrics and the leading cause of maternal death worldwide. The key to reduce the incidence of its adverse outcomes lies in early and rapid identification and timely intervention. However, the clinical diagnostic criteria are mostly based on visual estimation of blood loss, and the severity of hemorrhage is likely to be underestimated, which can easily leads to delayed clinical diagnosis and treatment of postpartum hemorrhage. In recent years, a number of studies have proposed that shock index (SI) can alert hemodynamic instability and be used to predict the occurrence, development and adverse outcome of postpartum hemorrhage. Especially in areas with scarce medical resources, the application value of SI is greater. The relative delta-shock index (ΔSI) can further individualize the assessment of bleeding. SI as a predictor of postpartum hemorrhage has some limitations, but overall, its clinical value is worthy of recognizing.

Key words: Postpartum hemorrhage, Shock, hemorrhagic, Hemodynamics, Forecasting, Shock index, Delta-shock index

QIN Shi-yi, SHAO Yong. Research Progress on the Application of Shock Index in Postpartum Hemorrhage[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 491-496.

References 36

[1]	Kumaraswami S, Butwick A. Latest advances in postpartum hemorrhage management[J]. Best Pract Res Clin Anaesthesiol, 2022, 36(1):123-134. doi: 10.1016/j.bpa.2022.02.004. pmid: 35659949
[2]	国家统计局. 《中国妇女发展纲要(2011—2020年)》终期统计监测报告[N]. 中国信息报,2021-12-22,2.
[3]	马宏伟, 刘兴会. 产后出血病因构成的变迁及应对措施[J]. 实用妇产科杂志, 2021, 37(3):165-168.
[4]	刘兴会, 张力, 张静. 《产后出血预防与处理指南(草案)》(2009)及《产后出血预防与处理指南(2014年版)》解读[J]. 中华妇幼临床医学杂志(电子版), 2015(4):433-447. doi: 10.3877/cma.j.issn.1673-5250.2015.04.002.
[5]	Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage[J]. Obstet Gynecol, 2017, 130(4):e168-e186. doi: 10.1097/AOG.0000000000002351.
[6]	Gonzalez-Brown V, Schneider P. Prevention of postpartum hemorrhage[J]. Semin Fetal Neonatal Med, 2020, 25(5):101129. doi: 10.1016/j.siny.2020.101129.
[7]	冯强, 张月香. 产后出血的治疗[J]. 国际妇产科学杂志, 2022, 49(5):574-579. doi: 10.12280/gjfckx.20220269.
[8]	Borovac-Pinheiro A, Priyadarshani P, Burke TF. A review of postpartum hemorrhage in low-income countries and implications for strengthening health systems[J]. Int J Gynaecol Obstet, 2021, 154(3):393-399. doi: 10.1002/ijgo.13618. pmid: 33529365
[9]	Allgöwer M, Burri C. "Shock index"[J]. Dtsch Med Wochenschr, 1967, 92(43):1947-1950. doi: 10.1055/s-0028-1106070.
[10]	Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition[J]. Crit Care, 2019, 23(1):98. doi: 10.1186/s13054-019-2347-3.
[11]	Chowdhury S, Parameaswari PJ, Leenen L. Outcomes of Trauma Patients Present to the Emergency Department with a Shock Index of ≥1.0[J]. J Emerg Trauma Shock, 2022, 15(1):17-22. doi: 10.4103/jets.jets_86_21. pmid: 35431481
[12]	Vang M, Østberg M, Steinmetz J, et al. Shock index as a predictor for mortality in trauma patients: a systematic review and meta-analysis[J]. Eur J Trauma Emerg Surg, 2022, 48(4):2559-2566. doi: 10.1007/s00068-022-01932-z.
[13]	Dai G, Lu X, Xu F, et al. Early Mortality Risk in Acute Trauma Patients: Predictive Value of Injury Severity Score, Trauma Index, and Different Types of Shock Indices[J]. J Clin Med, 2022, 11(23):7219. doi: 10.3390/jcm11237219.
[14]	Escobar MF, Nassar AH, Theron G, et al. FIGO recommendations on the management of postpartum hemorrhage 2022[J]. Int J Gynaecol Obstet, 2022, 157(Suppl 1):3-50. doi: 10.1002/ijgo.14116.
[15]	Rady MY, Smithline HA, Blake H, et al. A comparison of the shock index and conventional vital signs to identify acute, critical illness in the emergency department[J]. Ann Emerg Med, 1994, 24(4):685-690. doi: 10.1016/s0196-0644(94)70279-9. pmid: 8092595
[16]	Le Bas A, Chandraharan E, Addei A, et al. Use of the “obstetric shock index” as an adjunct in identifying significant blood loss in patients with massive postpartum hemorrhage[J]. Int J Gynaecol Obstet, 2014, 124(3):253-255. doi: 10.1016/j.ijgo.2013.08.020.
[17]	Rojas-Suarez J, Paternina-Caicedo Á, Tolosa JE, et al. The impact of maternal anemia and labor on the obstetric Shock Index in women in a developing country[J]. Obstet Med, 2020, 13(2):83-87. doi: 10.1177/1753495X19837127.
[18]	Ushida T, Kotani T, Imai K, et al. Shock Index and Postpartum Hemorrhage in Vaginal Deliveries: A Multicenter Retrospective Study[J]. Shock, 2021, 55(3):332-337. doi: 10.1097/SHK.0000000000001634.
[19]	Lee SY, Kim HY, Cho GJ, et al. Use of the shock index to predict maternal outcomes in women referred for postpartum hemorrhage[J]. Int J Gynaecol Obstet, 2019, 144(2):221-224. doi: 10.1002/ijgo.12714.
[20]	Pacagnella RC, Borovac-Pinheiro A, Silveira C, et al. The golden hour for postpartum hemorrhage: Results from a prospective cohort study[J]. Int J Gynaecol Obstet, 2022, 156(3):450-458. doi: 10.1002/ijgo.13823.
[21]	Attali E, Many A, Kern G, et al. Predicting the need for blood transfusion requirement in postpartum hemorrhage[J]. J Matern Fetal Neonatal Med, 2022, 35(25):7911-7916. doi: 10.1080/14767058.2021.1937992.
[22]	Sohn CH, Kim YJ, Seo DW, et al. Blood lactate concentration and shock index associated with massive transfusion in emergency department patients with primary postpartum haemorrhage[J]. Br J Anaesth, 2018, 121(2):378-383. doi: 10.1016/j.bja.2018.04.039. pmid: 30032876
[23]	Oglak SC, Obut M, Tahaoglu AE, et al. A prospective cohort study of shock index as a reliable marker to predict the patient′s need for blood transfusion due to postpartum hemorrhage[J]. Pak J Med Sci, 2021, 37(3):863-868. doi: 10.12669/pjms.37.3.3444.
[24]	Fu CJ, Irama W, Wong YC, et al. Transarterial embolization for postpartum hemorrhage: lessons learned[J]. Acta Radiol, 2018, 59(12):1451-1457. doi: 10.1177/0284185118769691.
[25]	Nathan HL, Seed PT, Hezelgrave NL, et al. Shock index thresholds to predict adverse outcomes in maternal hemorrhage and sepsis: A prospective cohort study[J]. Acta Obstet Gynecol Scand, 2019, 98(9):1178-1186. doi: 10.1111/aogs.13626.
[26]	Maneschi F, Perrone S, Di Lucia A, et al. Shock parameters and shock index during severe post-partum haemorrhage and implications for management: a clinical study[J]. J Obstet Gynaecol, 2020, 40(1):40-45. doi: 10.1080/01443615.2019.1603210. pmid: 31303082
[27]	Kohn JR, Dildy GA, Eppes CS. Shock index and delta-shock index are superior to existing maternal early warning criteria to identify postpartum hemorrhage and need for intervention[J]. J Matern Fetal Neonatal Med, 2019, 32(8):1238-1244. doi: 10.1080/14767058.2017.1402882. pmid: 29113517
[28]	Tanacan A, Fadiloglu E, Unal C, et al. Importance of shock index in the evaluation of postpartum hemorrhage cases that necessitate blood transfusion[J]. Women Health, 2020, 60(9):1070-1078. doi: 10.1080/03630242.2020.1802638. pmid: 32757719
[29]	Borovac-Pinheiro A, Pacagnella RC, Morais SS, et al. Standard reference values for the shock index during pregnancy[J]. Int J Gynaecol Obstet, 2016, 135(1):11-15. doi: 10.1016/j.ijgo.2016.03.024. pmid: 27352739
[30]	Borovac-Pinheiro A, Cecatti JG, de Carvalho Pacagnella R. Ability of shock index and heart rate to predict the percentage of body blood volume lost after vaginal delivery as an indicator of severity: results from a prospective cohort study[J]. J Glob Health, 2019, 9(2):020432. doi: 10.7189/jogh.09.020432.
[31]	Nathan HL, de Greeff A, Hezelgrave NL, et al. An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2[J]. Blood Press Monit, 2015, 20(1):52-55. doi: 10.1097/MBP.0000000000000086. pmid: 25243711
[32]	Giblin L, Vousden N, Nathan H, et al. Effect of the CRADLE vital signs alert device intervention on referrals for obstetric haemorrhage in low-middle income countries: a secondary analysis of a stepped- wedge cluster-randomised control trial[J]. BMC Pregnancy Childbirth, 2021, 21(1):317. doi: 10.1186/s12884-021-03796-4.
[33]	Nathan HL, El Ayadi A, Hezelgrave NL, et al. Shock index: an effective predictor of outcome in postpartum haemorrhage?[J]. BJOG, 2015, 122(2):268-275. doi: 10.1111/1471-0528.13206.
[34]	El Ayadi AM, Nathan HL, Seed PT, et al. Vital Sign Prediction of Adverse Maternal Outcomes in Women with Hypovolemic Shock: The Role of Shock Index[J]. PLoS One, 2016, 11(2):e0148729. doi: 10.1371/journal.pone.0148729.
[35]	Drew T, Carvalho J, Subramanian C, et al. The association of shock index and haemoglobin variation with postpartum haemorrhage after vaginal delivery: a prospective cohort pilot study[J]. Int J Obstet Anesth, 2021, 45:67-73. doi: 10.1016/j.ijoa.2020.10.010. pmid: 33298343
[36]	Makino Y, Miyake K, Okada A, et al. Predictive accuracy of the shock index for severe postpartum hemorrhage in high-income countries: A systematic review and meta-analysis[J]. J Obstet Gynaecol Res, 2022, 48(8):2027-2037. doi: 10.1111/jog.15292.