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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(489) Estimated versus Quantitative Blood Loss and Associated Hemorrhagic Complications: A Pre- and Post-Intervention Study

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
American College of Obstetrics and Gynecology (ACOG) has recommended using quantitative blood loss (QBL) rather than estimated blood loss (EBL) to accurately measure blood loss during delivery and enable clinicians to promptly identify and treat hemorrhage. Despite the theoretical benefits of ascertaining a more accurate representation of blood loss, there is limited evidence that demonstrates an improvement in clinical outcomes, such as the rate of blood transfusion.

Study Design:
We performed a pre- and post- analysis of the use of EBL versus QBL. The primary outcome was to compare the rate of blood transfusion. Secondary outcomes included hospital length of stay, rate of hysterectomy, and maternal death.

Results:
A total of 46,554 deliveries performed at a single large tertiary hospital were analyzed (Table 1). Of these, 35,255 (75.3%) utilized EBL and 11,541 (24.7%) utilized QBL. The percentage of deliveries by cesarean section was 32.48% (N=11,451) in the EBL group and 33.43% (N=3,858) in the QBL group. Patients in the QBL group were more likely to receive a blood transfusion during their care when compared to the EBL group (3.58% versus 5.94%; OR = 1.70, 95% CI 1.55, 1.87; p > 0.001). The rate of hysterectomy was 0.03% in both the QBL and EBL groups (p = 0.89). The average length of stay in the EBL group was 3.01 days, equal to that of the QBL group. There were no maternal deaths reported.

Conclusion:
This study calls into question the ACOG recommendation to use QBL over EBL, as the use of QBL appears to increase the likelihood of receiving a blood transfusion without any impact on additional adverse maternal hematologic outcomes or maternal mortality.