488: CLASSIFICATION AND STRATIFICATION OF HEMORRHAGIC SHOCK IN OBSTETRICS: A LATIN AMERICAN STUDY

Introduction: Obstetric haemorrhage remains one of the leading causes of maternal death worldwide. Methods: This is a descriptive, multicentre study conducted in hospitals in four Latin American countries (Colombia, Mexico, Guatemala and Ecuador). The objective was to characterise Hypovolemic shock in obstetric patients by recording estimated blood loss and clinical and haemodynamic variables. Parameters such as blood pressure (systolic, diastolic and mean), heart and respiratory rates, level of consciousness and capillary fill time were measured. Two methodologies were employed to categorise the severity of shock: a subjective clinical assessment, and an objective assessment based on the Shock Index. a modified severity scale for classifying haemorrhagic shock in mothers. Results: A total of 222 patients were analysed. The clinical assessment of shock was categorised as Severe (34.2%, n = 76); Moderate (51.3%, n = 114); Mild (7.2%, n = 16); Absent in 7.2% (n = 16). The average Shock Index for these groups was 1.23. 0.84 and 0.73, respectively. No maternal mortality was recorded, but perinatal mortality was 11% (n = 26). When the subjective classification was compared with the modified scale, The following significant findings were observed: - Severe shock (subjective): 53.9% of these of these patients corresponded to a severe degree on the objective scale, while 34.2% were moderate. - Moderate shock (subjective): 48.2% corresponded to the moderate category On the scale, while 23.7% were reclassified as severe. - Mild shock: (subjective): According to the scale, 56.3% of patients were categorised as mild. The remaining 33.8% were reclassified as moderate (31.3%) or severe (12.5%). Significant differences were found. in outcomes such as perinatal mortality and the need for major surgical interventions (e.g. hysterectomy) between the groups. Conclusions: Early recognition and clinical assessment of hypovolemic shock are essential. However, objective classification using tools such as the Shock Index (SI) and standardised scales is crucial for more accurate assessment and predicting unfavourable outcomes. There is a need to develop and validate predictive models that allow for the earlier identification and management of obstetric patients.