CLINICAL UTILITY OF SHOCK INDEX IN THE EARLY DETECTION OF ADVERSE OUTCOMES IN POSTPARTUM HEMORRHAGE

Background: Postpartum hemorrhage is a major cause of maternal morbidity and mortality. Shock Index (SI), defined as heart rate (HR) divided by systolic blood pressure (SBP), is emerging as a valuable early predictor of hemodynamic instability.

Objective: This study evaluates the role of SI in predicting adverse maternal outcomes, including need for ICU admission, need forblood transfusion, and surgical intervention.

Materials and Methods: A prospective cohort study was conducted from March 2023 to March 2024 at Dr.B.R.A.M Hospital, Raipur, involving 65 patients diagnosed with PPH. SI was measured at 15-minute intervals for 1 hour post-delivery. The primary outcomes included need for ICU admission, need for blood transfusion, and surgical intervention.

Results: SI>1.1 was significantly associated with increased ICU admissions (40%), need for massive transfusion (68%), and surgical interventions (55%). ROC curve analysis demonstrated an area under the curve (AUC) of 0.80, indicating strong predictive value of SI.

Conclusion: SI is an effective tool for early detection of hemodynamic instability in PPH and should be integrated into obstetric early warning systems for better maternal outcomes.