Assaf Wisam, Gruber Maya, Shalabna Eiman, Nahshon Chen, Kedar Reuven, Lavie Ofer, Segev Yakir, Sagi-Dain Lena
Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Rappaport Faculty of Medicine, Technion University, Haifa, Israel.
Int J Gynaecol Obstet. 2025 Jan;168(1):205-209. doi: 10.1002/ijgo.15835. Epub 2024 Aug 2.
The aim of this study was to assess the usefulness of routine hemoglobin testing following elective and urgent cesarean section (CS) in patients without primary postpartum hemorrhage (PPH).
This retrospective cohort study included women who underwent vaginal delivery (VD), elective CS, and urgent CS at Carmel Medical Center from 2015 to 2020. Data were extracted from the obstetric database, excluding deliveries with PPH. Demographic and obstetric variables were recorded. Primary outcomes were the need for packed red blood cell transfusion.
A total of 19 446 women were included, with five (0.3%) requiring a blood transfusion in the elective CS group, 27 (0.17%) in the VD group, and eight (0.4%) in the urgent CS group. Urgent CS was associated with a higher risk of blood transfusion, but there was no significant difference between elective CS and VD. Elective CS showed the lowest rates of post-delivery hemoglobin below 7 g/dL 1 (0.1%) compared to VD 16 (0.6%) and urgent CS 13 (0.7%).
Routine postoperative hemoglobin testing following elective CS in asymptomatic patients without PPH appears unnecessary. This study supports reconsidering routine hemoglobin testing following elective CS, aligning with the goal of optimizing resource utilization while maintaining patient quality.
本研究旨在评估在无原发性产后出血（PPH）的患者中，择期和急诊剖宫产（CS）后进行常规血红蛋白检测的实用性。
这项回顾性队列研究纳入了2015年至2020年在卡梅尔医疗中心接受阴道分娩（VD）、择期CS和急诊CS的女性。数据从产科数据库中提取，排除有PPH的分娩。记录人口统计学和产科变量。主要结局是是否需要输注浓缩红细胞。
总共纳入了19446名女性，择期CS组中有5名（0.3%）需要输血，VD组中有27名（0.17%），急诊CS组中有8名（0.4%）。急诊CS与输血风险较高相关，但择期CS和VD之间没有显著差异。与VD组的16名（0.6%）和急诊CS组的13名（0.7%）相比，择期CS组产后血红蛋白低于7g/dL的发生率最低，为1名（0.1%）。
对于无PPH的无症状患者，择期CS后进行常规术后血红蛋白检测似乎没有必要。本研究支持重新考虑择期CS后的常规血红蛋白检测，这与优化资源利用同时保持患者质量的目标相一致。
