The value of routine hemoglobin level evaluation following elective cesarean section: Is it worthwhile?

Area of Science:

• Obstetrics and Gynecology
• Clinical Pathology
• Health Services Research

Background:

• Postpartum hemorrhage (PPH) is a significant concern after childbirth.
• Hemoglobin testing is a common postoperative assessment.
• The utility of routine hemoglobin testing after cesarean section (CS) without PPH is debated.

Purpose of the Study:

• To evaluate the necessity of routine postoperative hemoglobin testing in patients undergoing elective or urgent cesarean section (CS) without primary postpartum hemorrhage (PPH).

Main Methods:

• Retrospective cohort study.
• Inclusion of women from vaginal delivery (VD), elective CS, and urgent CS groups (2015-2020).
• Exclusion of deliveries with PPH; data extracted from obstetric database.

Main Results:

• 19,446 women included; transfusion rates: 0.3% (elective CS), 0.17% (VD), 0.4% (urgent CS).
• Urgent CS showed higher transfusion risk; no significant difference between elective CS and VD.
• Lowest rates of post-delivery hemoglobin <7 g/dL observed in the elective CS group (0.1%).

Conclusions:

• Routine postoperative hemoglobin testing is likely unnecessary for asymptomatic patients after elective CS without PPH.
• Reconsidering routine hemoglobin testing after elective CS can optimize resource utilization.
• Maintaining high-quality patient care is achievable without routine postoperative hemoglobin testing in select CS cases.