ABSTRACT
Accurate measurement of fluid intake and output is an important part of the assessment of women who are unwell, and yet it is frequently observed that records of fluid balance are incomplete, confusing or difficult to maintain accurately. In simple terms, assessment and recording of fluid balance by measuring what goes in and what comes out should be straightforward. Strict fluid balance records need to be kept, including regular assessment of fluid restrictions and review of hourly urine output. Fluid compartments are classified as separate areas, water and electrolytes continually circulate between them. The midwife needs to understand when and why fluids are needed and what fluid replacement is aiming to achieve, and be able to assess the effectiveness of fluid administration. Most cases of rapid fluid replacement are given in response to haemorrhage. Blood transfusion is often required in cases of significant haemorrhage to replace vital oxygen-carrying red cells.
