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study situat ions and ma y be up t o abo ut 50 percent l ower ( 157 ­
159 ] . Ma ny s tudies i nd icate that average nor mal postpartum
blood l o s s e s range between 300-700 mis [ 157 - 160 ). In a
compa r a t i ve study by Br aut in 1967 , for example , he noted that
whereas only 6% of SUbjects were r e c or ded as having ha d
postpartum haemorrhage by medi cal staff us ing conventional
measuring methods and estimates, t he f i g u r e rose t o 21. 5% when
a c c u r a t e blood mea s urement readings were u s e d ( 15 9 ] .
I n an a naemi c patient, this difference is important,
especially since a small estimated blood vo l u me l o s s c ou l d
give a fa lse sense o f security, when i n fact significant a nd
potentially hazardous loss ha s occurred. In a r e t r o s pect i ve
stUdy of severely anaemic pregnant patients in Malaysia, for
55
example, only 1.5% were r e co r ded as having postpartum
haemorrhage but the r e s e a r ch e r s observed t ha t these anaem ic
su bjects wer e mor e prone to shock even when their recorded
l os s e s were s tated t o be small [1 47 ) .
I n developing countries, many anaemic women go t hrough
r e pe a t ed pregnancies wi t h l ittl e chanc e of recovery in
between, and therefore even small amounts of postpartum blood
l oss can be an important contri buting cause t o the development
o r c h r on i c anaemia during t he ch i l d bearing years.
Some 50 years ago, in a North American s tudy, the
incidence of pos t pa r t um haemorrhage in some stUdies was
observed to be about 15% of vaginal deliveries (161 ] . Today,