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International Journal of Gynecology & Obstetrics / Volume 151, Issue 1 / p. 83-90

CLINICAL ARTICLE

What is the normal range of obstetric shock index in the immediate

postpartum period in a low-resource setting?

Johnbosco I. Nwafor !, Chuka N. Obi, Olisah E. Onuorah, Blessing I. Onwe,

Chukwunenye C. Ibo, Victor U. Onuchukwu

First published: 03 July 2020

https://doi.org/10.1002/ijgo.13297
Citations: 1

Abstract

Objective
To determine the normal range of shock index (SI), blood pressure (BP), mean
arterial pressure (MAP) and heart rate (HR) among postpartum women in a low-
resource setting.

Methods
In a prospective cohort study, vital signs were recorded 1 hour after delivery
among postpartum women with normal blood loss who delivered in Abakaliki,
Nigeria, from April to July 2019.

Results
Among 225 women, the median (95% reference range) was 120 (100–155.8), 70
(60–94), and 90 (66.5–116.6) mm Hg for systolic BP, diastolic BP, and MAP,
respectively; 82 (65–102) bpm for HR; and 0.69 (0.48–0.89) for SI. The upper SI
limit of 0.89 supported the current value of 0.9 as the upper limit; however, the
lower SI limit of 0.48 corresponded to the current lower limit for a non-obstetric
population (0.5). The SI of more than half of the study women (n=126; 56.0%)
was within the normal range for non-obstetric women (0.5–0.7).

Conclusion
 Although hemodynamic changes in pregnancy widen the SI range, 56.0% of
women maintained SI within the non-obstetric reference range. In low-resource
settings, the current normal obstetric SI range of 0.7–0.9 should be revised to
0.5–0.9 to accommodate this lower threshold.

CONFLICTS OF INTEREST
The authors have no con"icts of interest.

Citing Literature #
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