Bodur Serkan, Gun Ismet, Ozdamar Ozkan, Babayigit Mustafa Alparslan
Department of Obstetrics and Gynecology, GATA Ankara, Turkey.
Department of Obstetrics and Gynecology, GATA Haydarpasa Training Hospital Istanbul, Turkey.
Int J Clin Exp Med. 2015 Nov 15;8(11):21653-8. eCollection 2015.
Hemorrhage still continues to be reported as one of the leading causes of maternal mortality and morbidity. Intraoperative estimation of the blood loss seems to be complex and misleading as it is impaired by the amount of amniotic fluid and blood from the placenta. The present study was aimed to investigate the safety of intraoperative deciding on an uneventful cesarean section in a low risk patient population.
One hundred patients free from hemorrhage risks and experienced an uneventful elective cesarean section, were included to the study. The decline in hemoglobin and hematocrit values, calculated blood loss, transfusion rate and presence of hemorrhage related symptoms and signs were accepted as the main outcomes of the study.
The average preoperative and postoperative hemoglobin values were detected as 12.09±0.18 g/dl and 10.72±1.39 g/dl, respectively. The average decrease in hemoglobin was 1.36±1.06 g/dl. The observed decrease in hemoglobin values were less than 10% in 34.4% of the patients. The average blood loss was calculated to be 517.06±417.55 ml. There were no patients with signs and symptoms of hemorrhage. Cross match transfusion ratio, transfusion probability and transfusion index was calculated as zero.
The decision of uneventful cesarean section provides obstetricians a safe postoperative and postpartum period after following standardized surgical procedures in terms of hemorrhage and related complications.
出血仍然是孕产妇死亡和发病的主要原因之一。术中对失血量的估计似乎很复杂且具有误导性,因为羊水和胎盘出血的量会影响估计。本研究旨在调查在低风险患者群体中,术中决定进行顺利剖宫产的安全性。
本研究纳入了100例无出血风险且经历了顺利择期剖宫产的患者。血红蛋白和血细胞比容值的下降、计算得出的失血量、输血率以及出血相关症状和体征的存在被视为研究的主要结果。
术前和术后血红蛋白的平均检测值分别为12.09±0.18 g/dl和10.72±1.39 g/dl。血红蛋白的平均下降值为1.36±1.06 g/dl。34.4%的患者观察到的血红蛋白值下降小于10%。计算得出的平均失血量为517.06±417.55 ml。没有患者出现出血的症状和体征。交叉配血输血率、输血概率和输血指数计算为零。
在出血及相关并发症方面,遵循标准化手术程序后,顺利剖宫产的决定为产科医生提供了一个安全的术后和产后时期。