Ushida T, Kotani T, Imai K, et al. - Calculation of shock index (SI) is done to detect hemodynamic instability and hypovolemia. Researchers here examined its utility in detecting postpartum hemorrhage (PPH) in vaginal deliveries using clinical data from 12 primary maternity care units in Japan. They conducted this multicenter retrospective study including a total of 30,820 women who delivered vaginally at term at 12 primary maternity care units from January 2012 to December 2018. In women with blood loss of < 500 mL, average SI trended nearly 0.7 during labor and the immediate postpartum period. Overall findings suggest better predictive value of SI for PPH detection in vaginal deliveries than other vital signs. However, they emphasize incorporation of other vital signs and symptoms linked with hypovolemic shock in clinical judgment due to the low sensitivity of SI.