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Acta Obstet Gynecol Scand. 2010 May;89(5):658-63. doi: 10.3109/00016341003605727.

Risks for peroperative excessive blood loss in cesarean delivery.

Author information

1
Department of Obstetrics and Gynecology, Innlandet Hospital Trust, Lillehammer, Norway. toril.kolas@sykehuset-innlandet.no

Abstract

OBJECTIVE:

To analyze risk factors for peroperative excessive blood loss at cesarean delivery.

DESIGN:

Case-control study.

SETTING:

Twenty-four of 26 maternity units in Norway with at least 500 expected deliveries per year.

SAMPLE:

A total of 2,778 women having singleton deliveries and participating in the Norwegian Breakthrough Project on Cesarean Section.

METHODS:

Elective and emergency operations were analyzed separately with extensive blood loss defined as hemorrhage > 1000 ml with controls defined as bleeding < 500 ml. All analyzes were done in SPSS (version 16.0) with chi-squared tests and logistic regression.

MAIN OUTCOME MEASURES:

Adjusted odds ratios (aOR) of extensive peroperative bleeding.

RESULTS:

The prevalence of excessive blood loss differed between women undergoing elective (2.1%) and emergency cesarean deliveries (3.3%). Among maternal factors, chronic maternal diseases, pregnancy and delivery related conditions, placenta previa (aOR 19.7; 95% CI 5.4-72.2) and transverse lie (aOR 4.9; 95% CI 0.9-26.5) were the only risk factors for extensive blood loss in elective operations, whereas placenta previa (aOR 8.4; 95% CI 2.4-29.9), placental abruption (aOR 2.0; 95% CI 2.0-14.5), intervention at full cervical dilation (aOR 3.2; 95% CI 1.4-7.1) and high BMI (aOR 3.4; 95% CI 1.6-7.2) were risks in emergency operations.

CONCLUSION:

The different risk pattern for excessive bleeding in cesarean deliveries should be recognized when planning available obstetric competence for surgery.

PMID:
20218934
DOI:
10.3109/00016341003605727
[Indexed for MEDLINE]
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