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Pre-caesarean section haemoglobin: a worthless investigation.

J R Allsop1, J J Morrison, A Prentice

  • 1Department of Obstetrics and Gynaecology, Rosie Maternity Hospital, Cambridge, UK.

International Journal of Obstetric Anesthesia
|April 1, 1996
PubMed
Summary

Routine pre-operative hemoglobin measurement before caesarean sections may be unnecessary. A third-trimester hemoglobin level accurately predicts levels at term, potentially saving costs and resources.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology

Background:

  • Hemoglobin concentration is routinely measured before caesarean sections and for anemia screening in early pregnancy.
  • The clinical utility of repeat hemoglobin measurements immediately before term delivery is questioned.

Purpose of the Study:

  • To investigate if a normal hemoglobin concentration in early pregnancy predicts hemoglobin levels at term delivery.
  • To determine if repeat hemoglobin testing before caesarean section provides additional useful information.

Main Methods:

  • A study of 106 patients undergoing elective (n=45) and emergency (n=61) caesarean sections.
  • Comparison of hemoglobin concentrations measured in early third trimester with those measured immediately before surgery at term.

Main Results:

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  • In most patients (elective and emergency), hemoglobin concentration increased by term.
  • A minority of patients experienced a fall in hemoglobin, with the largest drop being 1.3 g/dl.
  • No clinically significant changes in hemoglobin were observed, with the lowest term value at 10.1 g/dl.

Conclusions:

  • Hemoglobin levels measured early in the third trimester can guide peri-operative management for caesarean sections.
  • Routine pre-operative hemoglobin testing before caesarean section may not be necessary, offering potential financial savings.