Blood transfusion and cesarean delivery.

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Pediatrics; Obstetrics & Gynecology
Creator Varner, Michael W.
Other Author Rouse, Dwight J.; MacPherson, Cora; Landon, Mark; Leveno, Kenneth J.; Moawad, Atef H.; Spong, Catherine Y.; Caritis, Steve N.; Meis, Paul J.; Wapner, Ronald J.; Sorokin, Yoram; Miodovnik, Menachem; Carpenter, Marshall; Peaceman, Alan M.; O'Sullivan, Mary Jo; Sibai, Baha M.; Langer, Oded; Thorp, John M.; Ramin, Susan M.; Mercer, Brian M.; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Title Blood transfusion and cesarean delivery.
Date 2006-10
Description OBJECTIVE: To evaluate risks for intraoperative or postoperative packed red blood cell transfusion in women who underwent cesarean delivery. METHODS: This was a 19-university prospective observational study. All primary cesarean deliveries from January 1, 1999, to December 31, 2000, and all repeat cesareans from January 1, 1999, to December 31, 2002, were included. Trained, certified research nurses performed systematic data abstraction. Primary and repeat cesarean deliveries were analyzed separately. Univariable analyses were used to inform multivariable analyses. RESULTS: A total of 23,486 women underwent primary cesarean delivery, of whom 762 (3.2%) were transfused (median 2 units, 25th% to 75th% 2-3 units). A total of 33,683 women underwent repeat [corrected] cesarean delivery, and 735 (2.2%) were transfused (median 2 units, 25th% to 75th% 2-4 units). Among primary cesareans, general anesthesia (odds ratio [OR] 4.2, 95% confidence interval [CI] 3.5-5.0), placenta previa (OR 4.8, CI 3.5-6.5) and severe (hematocrit less than 25%) preoperative anemia (OR 17.0, CI 12.4-23.3) increased the odds of transfusion. Among repeat cesareans, the risk was increased by general anesthesia (OR 7.2, CI 5.9-8.7), a history of five or more prior cesareans (OR 7.6, CI 4.0-14.3), placenta previa (OR 15.9, CI 12.0-21.0), and severe preoperative anemia (OR 19.9, CI 14.5-27.2). CONCLUSION: Overall, the risk of transfusion in association with cesarean is low. However, both severe preoperative maternal anemia and placenta previa are associated with markedly increased risks. The former argues for optimizing maternal antenatal iron status to avoid severe anemia and the latter for careful perioperative planning when previa complicates cesarean. LEVEL OF EVIDENCE: II-2.
Type Text
Publisher Lippincott, Williams & Wilkins
Volume 108
Issue 4
First Page 891
Last Page 897
Subject Blood Transfusion; Postpartum Hemorrhage; Pregnancy Complications; Anemia
Subject MESH Blood Transfusion; Cesarean Section; Postpartum Hemorrhage; Anemia
Language eng
Bibliographic Citation Rouse DJ, MacPherson C, Landon M, Varner MW, Leveno KJ, Moawad AH, Spong CY, Caritis SN, Meis PJ, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Blood transfusion and cesarean delivery. Obstet Gynecol. 2006 Oct;108(4):891-7. Retrieved on May 30th 2007 from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
Rights Management Copyright © Wolters Kluwer, Obstetrics and Gynecology, 108, 891-7, 2006
Format Medium application/pdf
Identifier ir-main,1600
ARK ark:/87278/s6gx4vp0
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 703020
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gx4vp0
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