Do your OBs underestimate EBLs?

Hi...student nurse here...What is an EBL and a PPH?...Learning...thanks.

Everybody underestimates blood loss. Multiple studies have been done on this and it seems every time the practitioner is way off on the actual loss. Here is one study on midwives and physicians.

Glover P. Blood loss at delivery: how accurate is your estimation? Aust J Midwifery. 2003;2;21-24.

EBL = estimated blood loss

PPH = post partum hemorrhage

our docs do that all the time......

I was in a c section where they soaked about 45 laps and called the EBL 300mL.....the suction canister had about 800 mL in it! (i know that some of the fluid in the canister was irrigation fluid and amniotic fluid but patient was being sectioned for fetal intolerance to labor due to oligo)..... Hmmmmmm......

I had PPH after delivering my DD last year....read the 'birth report' and EBL was 1100cc - I didn't receive a blood transfusion- I'm not sure what my H&H was, but all I know is I passed out, don't remember much of the hours following the birth. But I've always been curious - in OB RN opinion, how severe of PPH is that considered? Dr. didn't act like it was that big of deal....

p.s. disclaimer...not asking medical advice just nursing opinion!

Thanks for the input.

They underestimate blood loss, and over score APGARS. Human nature to make yourself look "good", I guess.

I was in a workshop on management of PPH and they said that nurses tend to overestimate and docs to underestimate. I wish I could remember the source for it but I can't find it, sorry.

I have noticed that too...apgars of 10 and 10 on a 36wk c/s baby...

The only 10s I've seen were given by paramedics in the field.

We gave apgars of 10 to infants of OB staff. :)

At a certain EBL the chart may get reviewed by peers, prompting the practitioner to lowball the estimate. Perhaps when he was called on it he would say "whoops, I meant 3000, forgot the zero."

Nope not as a rule. They are quite honest, thankfully. And our apgar scoring is truthful. I don't see why people need to lie; in the end, it could really BITE.

A bit OT: we have an NNP who does not believe in apgars of 10, period. She says it's impossible. I disagree. I have seen a few (yes very few) kids with pink all they way to their last nail bed and if I see a 10, I score a 10; she can dispute it all day til the cows come home. I chart what I see.