Shock Index in Predicting Maternal Outcomes in Postpartum Hemorrhage

Authors: Dr. Monika Akare, Dr. Gaurang Narayan, Dr. Alka Patankar

This prospective cohort study evaluates the Shock Index (SI) and Modified Shock Index (MSI) as early, non-invasive predictors of adverse outcomes in postpartum hemorrhage (PPH). Conducted on 100 women with PPH, the study measured SI/MSI at multiple intervals and tracked outcomes like ICU admission, transfusion, DIC, and mortality.

Major findings include:

• SI ≥1.0 predicts transfusion needs, ≥1.04 indicates ICU risk, and ≥1.6 correlates with maternal mortality.

• MSI outperformed SI, with AUROC of 0.97 for transfusion prediction.

• Significant reduction in SI post-intervention validated its role in guiding timely management.

The study advocates for integrating SI/MSI into standard PPH protocols, especially in resource-limited settings, to improve maternal outcomes.