{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:45:41Z","timestamp":1776253541647,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: The study aimed to assess the accuracy of two distinct methods for estimating blood loss (EBL) and to identify potential factors contributing to early-onset postpartum hemorrhage (PPH) following a vaginal delivery (VD). Methods: Women in singleton pregnancies undergoing spontaneous\/induced VD were recruited for this prospective observational cohort study. Methods of EBL included: (1) visual assessment by an attending obstetrician (sEBL) and (2) implementation of a mathematical formula (fEBL). Early PPH was defined as a cumulative blood loss exceeding 500 mL within the first 24 h after delivery as reflected by clinical assessment. Results: During the study period, 485 women delivered vaginally, and early PPH was diagnosed in 29 cases (5.97%). Among patients with PPH, a significant increase in the duration of the 2nd (61 min. vs. 33.5 min., p &lt; 0.05) and 3rd (13 min. vs. 7 min., p &lt; 0.001) stages of labor, as well as in the application of a dinoprostone insert (31% vs. 10.5%, p &lt; 0.01) was noted. Additionally, in the same cohort, uterine atony (41.4% vs. 1.5%, p &lt; 0.001), 3rd\/4th degree perineal rupture (6.9% vs. 0%, p &lt; 0.01), fetal macrosomia (17.2% vs. 4.8%, p &lt; 0.05) and stillbirth (6.9% vs. 0.2%, p &lt; 0.05) occurred significantly more frequently. In both groups visual estimation of blood loss was significantly lower compared to fEBL: (PPH sEBL: 800 mL vs. fEBL 1439.6 mL, p &lt; 0.001; control sEBL: 250 mL vs. fEBL 621.8 mL, p &lt; 0.001). In the multivariate analysis, factors such as third stage of delivery time \u2265 30 min. (OR 11.6; 95% CI: 4.18\u201332.33), FBW \u2265 4000 g (OR 6.37; 95% CI: 1.54\u201326.3), and dinoprostone insert application (OR 4.33; 95%CI: 1.63\u201311.48) were selected as independent predictors of the PPH. Conclusions: Compared to mathematical formula, visual estimation of blood loss by an attending obstetrician is significantly decreased. Prolonged third stage of delivery, fetal macrosomia, and application of a dinoprostone insert are the strongest contributors to early PPH following a VD.<\/jats:p>","DOI":"10.3390\/jcm15083000","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T10:30:23Z","timestamp":1776249023000},"page":"3000","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accuracy of Blood Loss Estimation and Identification of Factors Contributing to Early Postpartum Hemorrhage Following Vaginal Delivery"],"prefix":"10.3390","volume":"15","author":[{"given":"Gabriela","family":"Afryka\u0144ska","sequence":"first","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"K\u0142opecka","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Maciocha","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Wyszy\u0144ska","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zofia","family":"W\u0142odarczyk","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1822-244X","authenticated-orcid":false,"given":"Szymon","family":"Paruszewski","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra Maria","family":"\u015aliwka","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-8661","authenticated-orcid":false,"given":"Artur Arkadiusz","family":"Ludwin","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-7546","authenticated-orcid":false,"given":"Pawe\u0142 Jan","family":"Stanirowski","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","unstructured":"MBRACE-UK (2023). 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