Routine 36-week hemoglobin and hematocrits: are they necessary?

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Clinical Laboratory Science

Background:

• Varied hemoglobin and hematocrit (H&H) screening schedules are employed for pregnant women across Air Force hospitals.
• Assessing the optimal timing for H&H screening is crucial for effective prenatal care and resource management.

Purpose of the Study:

• To evaluate the clinical utility of 36-week hemoglobin and hematocrit screening in pregnant women.
• To determine if 36-week screening offers advantages over 28-week screening or labor admission screening.

Main Methods:

• Retrospective chart review of 111 pregnant women delivering between November 1990 and February 1991.
• Analysis of hemoglobin and hematocrit values at 28 weeks, 36 weeks, and upon labor admission.

Main Results:

• Hemoglobin and hematocrit values were significantly lower at 28 weeks compared to 36 weeks (p > 0.01).
• Values at 36 weeks were significantly lower than those recorded upon labor admission (p > 0.01).
• 36-week screening did not correlate with improved prenatal care outcomes.

Conclusions:

• Screening hemoglobin and hematocrit at 36 weeks of gestation provides no discernible benefit to prenatal care.
• Implementing 36-week screening leads to increased patient discomfort and an elevated workload for clinical laboratories.
• Current screening protocols may require revision to optimize patient care and laboratory efficiency.