Factors associated with postcesarean blood transfusion: a case control study

Area of Science:

• Obstetrics and Gynecology
• Transfusion Medicine
• Maternal-Fetal Medicine

Background:

• Cesarean delivery (CD) is a significant risk factor for postpartum hemorrhage.
• Characteristics influencing the need for blood transfusion post-CD are not fully understood.

Purpose of the Study:

• To determine the rate of blood transfusion following cesarean delivery.
• To identify maternal and intrapartum factors associated with post-CD blood transfusion.

Main Methods:

• Retrospective case-control study involving women undergoing CD at a university hospital.
• Cases received blood transfusion post-CD; controls did not, in a 1:2 ratio.
• Analysis of maternal demographics, comorbidities, intrapartum events, and surgical factors.

Main Results:

• The overall post-CD blood transfusion rate was 4.7%.
• Independently associated factors included advanced maternal age, parity, gestational hypertensive disorders, comorbidities, lower predelivery hemoglobin, major placental abnormalities, nonelective procedure, prolonged second stage of labor, longer surgery duration, general anesthesia, and greater estimated blood loss.
• Eleven factors were identified as significantly associated with transfusion requirement.

Conclusions:

• Several maternal and intrapartum factors are associated with blood transfusion needs after cesarean delivery.
• Further prospective research is needed to develop prophylactic interventions for high-risk patients to reduce transfusion rates.