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What is the normal range of obstetric shock index in the immediate postpartum period in a low‐resource setting?
Author(s) -
Nwafor Johnbosco I.,
Obi Chuka N.,
Onuorah Olisah E.,
Onwe Blessing I.,
Ibo Chukwunenye C.,
Onuchukwu Victor U.
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13297
Subject(s) - medicine , blood pressure , obstetrics , population , hemodynamics , postpartum period , reference range , heart rate , pregnancy , prospective cohort study , diastole , mean arterial pressure , cardiology , genetics , environmental health , biology
Objective To determine the normal range of shock index (SI), blood pressure (BP), mean arterial pressure (MAP) and heart rate (HR) among postpartum women in a low‐resource setting. Methods In a prospective cohort study, vital signs were recorded 1 hour after delivery among postpartum women with normal blood loss who delivered in Abakaliki, Nigeria, from April to July 2019. Results Among 225 women, the median (95% reference range) was 120 (100–155.8), 70 (60–94), and 90 (66.5–116.6) mm Hg for systolic BP, diastolic BP, and MAP, respectively; 82 (65–102) bpm for HR; and 0.69 (0.48–0.89) for SI. The upper SI limit of 0.89 supported the current value of 0.9 as the upper limit; however, the lower SI limit of 0.48 corresponded to the current lower limit for a non‐obstetric population (0.5). The SI of more than half of the study women (n=126; 56.0%) was within the normal range for non‐obstetric women (0.5–0.7). Conclusion Although hemodynamic changes in pregnancy widen the SI range, 56.0% of women maintained SI within the non‐obstetric reference range. In low‐resource settings, the current normal obstetric SI range of 0.7–0.9 should be revised to 0.5–0.9 to accommodate this lower threshold.