Incidence and risk factors predicting blood transfusion in caesarean section

Abstract

In the absence of significant risk factors for haemorrhage at CS in a tertiary setting, routine blood type and screen testing does not enhance patient care. In the rare event that a patient without previously identifiable risk factors requires an urgent blood transfusion, O negative blood could be given in the interim pending formal determination of type and cross-match.

Risk factors for transfusion in cesarean section deliveries at a tertiary hospital

“…Our study has shown an overall lower transfusion rate of 0.53% compared to the published literature. Previous studies showed the transfusion rate for cesarean delivery ranging from 1.1% to 7.8% in developed countries and up to 25% in developing countries . The reason for this could be the increased proportion of elective cesarean sections by maternal request, which has led to a high cesarean rate of 54.73%.…”

“…As shown in other research, elective cesarean sections have less risk of requiring blood transfusion. Hence, the overall incidence of blood transfusion for cesarean delivery would be less …”

Establishing a perinatal red blood cell transfusion risk evaluation model for obstetric patients: a retrospective cohort study

“…Significant predictors of perinatal transfusion were identified by entering candidate risk factors (polyembryony [yes/no], anemia [yes/no], thrombocytopenia [yes/no], preeclampsia [yes/no], placenta previa [yes/no], placental implantation [yes/no], scarred uterus [yes/no], placental abruption [yes/no], residual placenta [yes/no], stillbirth [yes/no], HELLP [yes/no], hemophilia [yes/no], and heart disease [yes/no]) into a stepwise model. These risk factors have been associated with PPH or perinatal transfusion in other studies . We first conducted a series of univariate analyses for each risk factor.…”

Postpartum Hemorrhage on Labor and Delivery

“…59 As little as 0.35 IU of oxytocin is needed to initiate acceptable uterine tone in 90% of elective cesarean delivery patients. 60 35 Goodnough et al, 38 Ransom et al, 39 Chua et al, 40 Ransom et al, 41 Scavone et al, 42 Weiniger et al, 43 Cambic et al 44 *1 in 4,000 low-risk patients require blood products. 40 †Extra time is needed to discriminate between anti-D antibodies due to RhoGAM and any additional antibodies that could interfere with a type and cross.…”

“…60 35 Goodnough et al, 38 Ransom et al, 39 Chua et al, 40 Ransom et al, 41 Scavone et al, 42 Weiniger et al, 43 Cambic et al 44 *1 in 4,000 low-risk patients require blood products. 40 †Extra time is needed to discriminate between anti-D antibodies due to RhoGAM and any additional antibodies that could interfere with a type and cross. 44 zThe exact number of units determined by a patient-specific assessment of risk for massive blood loss, and institutional resources to rapidly procure additional blood products.…”