Re: confused about hgb & hct-something to add

• Messages sorted by: [ date ][ thread ][ subject ][ author ]
• Next message: D. Ashley Hill, M.D.: "Re: drug testing part of prenatal care?"
• Previous message: mary: "Re: Am I pregnant?"
• In reply to: Nicole: "confused about hgb & hct-something to add"

There are a lot of variables in this equation, but I will take a stab at some answers.

When blood is lost very abruptly, such as with childbirth, or trauma, the loss of blood will show much more clearly the day after the loss. The reason for this is that your body will compensate for sudden blood loss by replacing the blood with other fluid, but this takes some period of time. Therefor, a CBC right after the blood loss will generally not reflect all the blood lost, whereas a CBC hours later will show a sudden drop, even if the blood loss has now stopped.

Transfusions have a potential for complication, and we are slow to transfuse, particularly young, healthy women who can tolerate a low H/H better than an elderly woman. I would almost never consider transfusing a woman with normal blood pressure at rest and standing, or without abnormally rapid heart beat at rest. In the normal, average woman, this would rarely happen with a Hgb over 6-7 grams. I would not even consider transfusing a patient with a Hgb of 10.

As to an estimate of your blood loss, a 3% drop in Hct is generally regarded to correspond with a loss of about 500cc of blood, though this number will be significantly less if you had an IV, as the IV fluid would dilute your blood, thus lowering the Hct without any blood loss at all.

Judging from your pre- and post-delivery labs, your blood loss was certainly no more than average for a vaginal delivery, and possibly quite a bit less than average. Remember, studies suggest that the average blood loss from a vaginal delivery is probably about 1000-1200cc.

I hope this answers your questions.

--
William D. McIntosh, MD
Clarksville, TN

This is for educational purposes only.  It is not intended
 to replace consultation and examination by your physician
 or other health care provider.

• Next message: D. Ashley Hill, M.D.: "Re: drug testing part of prenatal care?"
• Previous message: mary: "Re: Am I pregnant?"
• In reply to: Nicole: "confused about hgb & hct-something to add"