Abbas Shahida, Mughal Saba, Hussain Syeda Namayah Fatima, Hossain Nazli
Shahida Abbas, FCPS, MCPS. Department of Obstetrics & Gynecology, Holy Family Hospital, Karachi, Pakistan.
Saba Mughal, Department of Research, DOW University of Health Sciences, Karachi, Pakistan.
Pak J Med Sci. 2019 Nov-Dec;35(6):1520-1525. doi: 10.12669/pjms.35.6.539.
Blood loss in cesarean deliveries has already been established in previous researches but a detailed insight into the correlates has not been done. This study examined whether the number of previous Cesarean sections is related to the need for blood transfusion, and risk factors for blood transfusion.
A retrospective review of 239 females who had undergone two or more Cesarean sections during the time period of 2015-2018 was done. Data collected included type of surgery (elective or emergency), age, parity, body mass index, estimated blood loss, operating time, level of surgeon, presence or absence of adhesions and number of transfused packed cell volume.
About 9.2% patients received blood transfusion with an estimated average blood loss of 618.18 ml. Patients with adhesions from previous surgery, presence of placenta previa, multiparity were significantly likely to receive blood transfusion. It was found that women with more than two caesarian sections had high proportion of blood transfusion as compared to women who had two caesarian sections. However non-significant difference was observed in numbers of caesarean sections with blood transfusion.
Women undergoing Cesarean sections combined with any of the risk factors like increased body mass index, dense adhesions, uterine atony, hypertension and presence of placenta previa, were found to be at increased risk for a need for blood transfusions.
剖宫产术中失血情况在以往研究中已有定论,但尚未对其相关因素进行深入探究。本研究旨在探讨既往剖宫产次数与输血需求之间的关系以及输血的危险因素。
对2015年至2018年期间接受过两次或更多次剖宫产的239名女性进行回顾性研究。收集的数据包括手术类型(择期或急诊)、年龄、产次、体重指数、估计失血量、手术时间、手术医生水平、是否存在粘连以及输注红细胞悬液的数量。
约9.2%的患者接受了输血,估计平均失血量为618.18毫升。既往手术有粘连、前置胎盘、多产次的患者输血可能性显著增加。结果发现,剖宫产次数超过两次的女性输血比例高于剖宫产两次的女性。然而,输血的剖宫产次数差异无统计学意义。
剖宫产女性若合并体重指数增加、粘连严重、子宫收缩乏力、高血压及前置胎盘等任何危险因素,输血需求风险会增加。