Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Validity of Gravimetric Measurement, Visual Guide Method, and Anesthesiologist Eyeball Visual Estimation of Blood Loss During Caesarian Section

Document Type : Original Article

Authors
Eman Ahmed Abas Al Swrameri 1
Shahla Alalaf 2
1 Department of Obstetrics and Gynaecology, Shahidan / Panjwin General Hospital, Penjwen District, Sulaimaniyah, Iraq.
2 Department of Obstetrics and Gynaecology, College of Medicine, Hawler Medical University, Erbil, Iraq.
10.22038/psj.2026.92182.1504
Abstract
Background:
Accurate estimation of blood loss during caesarean section (C/S) and rapid intervention is an essential way for the management of obstetric hemorrhage. This study was conducted to assess the accuracy of the visual guide and the anesthetist’s eyeball estimation methods compared to the gravimetric method during elective C/S.
 
methods:
A cross-sectional comparative study was conducted in Maternity Teaching Hospital, Erbil, Kurdistan Region, Iraq, from January 01, 2021, to November 01, 2021. A convenience sample of 100 women of elective C/S was included. Blood loss was estimated using the anesthetist’s eyeball method, visual guide pictogram, and gravimetric method. The collected data were analyzed and used to compare the different techniques.
 
Results:
There was a strong, significant correlation between each of the three practised methods for estimation of the blood loss during C/S (p<0.001). The mean of estimated blood loss by the gravimetric method (433.8±184.5 mL) was significantly (p≤0.05) less than the estimated means by the anaesthetist (492.5±188.2 mL) and by the visual guide estimation (478±185.2 mL).
 
Conclusions:
The visual guide method and anaesthetist eyeball estimation closely approximate blood measurement by the gravimetric method. Although the visual guide method and anaesthetist eyeball method were slightly higher than the gravimetric measurement of blood loss, this difference is unlikely to have led to errors in clinical judgment, such as over-transfusion or unrecognized massive maternal hemorrhage. The visual estimation of blood loss is a simple, fast, and readily available method for the initial evaluation of blood loss in C/S delivery.
Keywords
Caesarian section
visual guide method
blood loss
anaesthetist eyeball method
gravimetric method
Subjects
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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 3
Summer 2026
Pages 139-146