KUMJ | VOL. 11 | NO. 2 | ISSUE 42 | APRIL- JUNE, 2013
Post-Operative Drop in Hemoglobin and Need of Blood Transfusion in Cesarean Section at Dhulikhel Hospital, Kathmandu University Hospital
Singh B, Adhikari N, Ghimire S, Dhital S
Abstract: Background
Cesarean section has been identified as one of the commonest indication for blood
transfusion in obstetric practice because it involves risk of major intra-operative
blood loss. Different figures varying from less than 500 ml to more than 1000 ml
have been quoted as estimated blood loss associated with caesarean section. There
is also a wide variation in blood ordering practices for this surgery.
Objective
The objective of this study is to evaluate the blood ordering practice and transfusion
for cesarean sections at our institute, to see post-operative drop in hemoglobin and
hematocrit and to correlate those parameters with the duration between uterine
incision and repair.
Methods
In this prospective observational study, non-randomised purposive sample was
taken from 121 ladies who underwent elective and emergency cesarean section at
the department of obstetrics of Dhulikhel Hospital-Kathmandu University Hospital.
Post-cesarean drop in hemoglobin and hematocrit and their relation with duration
of uterine manipulation was calculated. Cross-match to transfusion (C/T ratio) ratio,
transfusion probability (%T) and transfusion index (Ti) were also calculated.
Results
Most frequent blood group was found to be O positive (38%) among those ladies.
Average post-cesarean drop in hemoglobin was 1.52±1.27 gm/dl and drop in
haematocrit was 5.49±4.1%. Post-operative drop in hemoglobin and haematocrit
had weak and positive linear relation with duration between uterine incision and
repair. Cross-match to transfusion ratio was 1, transfusion probability 100% and
transfusion index was 2.
Conclusion
There is no need of routine cross-matching of blood for cesarean section. Only
grouping with confirmation of availability should be done for emergency situation.
Keyword : Blood transfusion, cesarean Section, drop in hemoglobin
