EP12.14: Postpartum sonographic measurement of the inferior vena cava and correlation with hemoglobin levels

The Inferior Vein Cava (IVC) diameter reflects the pressure in the right atrium, which is a measure of cardiac preload; it is sensitive to blood volume and its diameter varies accordingly. The aim of our study was to evaluate the correlation between the IVC diameter, Collapsibility Index (CI) and the hemoglobin drop 24h after the delivery. Prospective cohort study conducted in two tertiary maternity centres. The study cohort consisted of women with singleton pregnancy submitted to an elective Caesarean Delivery at term. IVC diameters were measured by means of abdominal ultrasonography during inspiration (IVCi) and expiration (IVCe) and the CI was calculated as (IVCe-IVCi)/IVCe two hours after the delivery according to a standardised technique (see figure 1). The total blood loss (BL) was quantified using the quantitative measurement and the total amount of intravenous fluid administrated was recorded. Hemoglobin (Hb) was determined 24 hours after the Caesarean section (Hbt1) and the Hb drop was calculated as the difference between the Hbt1 value and the preoperatory value (HbT0). The primary outcome of the study was to assess the correlation between the CI and a Hb drop ≥ 2g. Overall 47 women were included for the study purpose with a mean maternal age of 35.6 ±5.8 years and a mean BMI of 23.8 ± 5.6. Mean estimated BL was 437± 388mL and mean CI 2 hours after delivery was 34%±21.6%. 11 (23.4%) women had a Hb drop ≥ 2g. After adjusting for the total amount of intravenous fluids administered no correlation between the CI and a Hb drop ≥ 2g was observed (p = 0.21) nor between the IVC diameter and a Hb drop ≥ 2g (p = 0.49). IVC diameter and CI assessed 2 hours after the delivery seem to be not associated with the occurrence of an Hb drop ≥ 2g. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.