Risk factors for blood transfusion in Cesarean section: A systematic review and meta-analysis

Iqbal, Kinza; Iqbal, Ayman; Rathore, Sawai Singh; Ahmed, Jawad; Ali, Shajeea Arshad; Farid, Eisha; Hasanain, Muhammad; Azeem, Qiraat; Memon, Farzana; Azim, Dua

doi:10.1016/j.tracli.2021.09.010

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…Therefore, the prediction of blood loss helps make transfusion decisions. Our ndings suggest that intraoperative blood loss can be approximated by known preoperative factors such as thrombocytopenia, placental disease, increased uterine contents, uterine myomas, ART, and obesity [4][5][6][7][8]. A meta-analysis also reported that spinal anesthesia causes less blood loss than general anesthesia [], which is compatible with our ndings.…”

Section: Discussionsupporting

confidence: 86%

A retrospective pilot study examining inhalation anesthesia after delivery on intraoperative blood loss in emergency cesarean section

Matsui

Matsuo

Yoneda

et al. 2022

Preprint

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Background After cesarean section delivery of a fetus, switching from inhalation to intravenous anesthesia is recommended to avoid atonic effects resulting from inhalation anesthetics. However, the clinical impact of inhalation anesthetic use remains unclear. This study aimed to examine the effects of inhalation anesthetic agents used after delivery on intraoperative blood loss in cesarean section. Methods A single-center retrospective study was performed using the clinical data of patients who underwent emergency cesarean section at an academic teaching hospital during a 7-year period from July 1, 2013, to June 30, 2020. Regression analyses were performed to determine the difference between inhalation anesthesia and propofol after delivery with regard to intraoperative blood loss. We also analyzed spinal anesthesia as a positive control to understand the absolute difference between inhalation and propofol.Results Of total, 511 patients were analyzed. Patients were 33.3 ± 5.4 years-old, had a body mass index of 25.1 ± 4.2 kg/m2, and were 34.8 ± 4.6 weeks of gestational age. Switching from inhalation anesthesia to propofol after delivery was performed in 123 patients, while 24 patients received no anesthesia switching (two propofol, 22 inhalation). Thus, propofol and inhalation anesthesia were used after cesarean delivery in 125 and 22 patients including 15 sevoflurane and seven desflurane. The remaining 364 patients were performed under spinal anesthesia. Univariate regression analysis showed that inhalation anesthesia use after delivery tended to reduce blood loss compared with propofol use after delivery, although this did not reach statistical significance (−171 mL; 95%CI, −388 to 46 mL). Multivariate regression analysis, including patients with spinal anesthesia, also showed that intraoperative blood loss using sevoflurane and desflurane after delivery was not significantly different from propofol (−155 mL; 95%CI, −344 to 35 mL). As a positive control, spinal anesthesia showed a significant reduction in blood loss compared with propofol use (−156 mL; 95%CI, −260 to −53 mL). Conclusion Our findings suggest that inhalation anesthetic agents used after delivery are not associated with increased blood loss during cesarean section. Further studies are needed to support our findings.

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Section: Discussionsupporting

confidence: 86%

A retrospective pilot study examining inhalation anesthesia after delivery on intraoperative blood loss in emergency cesarean section

Matsui

Matsuo

Yoneda

et al. 2022

Preprint

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“…The coagulation indexes before and after blood transfusion were compared, the changes of PT, APTT, Fbg, and D-D were signi cantly different after maternal blood transfusion and before blood transfusion (P < 0.05). Risk factors for blood transfusion in the cesarean section include placenta previa, placental abruption, emergency caesarean section, appointment status, multiple pregnancy, and preoperative hematocrit, while previous caesarean sections did not increase the risk of blood transfusion (Iqbal, et al, 2022). In a study by Kvalvik et al, women with SSI were almost three times more likely to be obese before pregnancy and four times more likely to have pre-existing psychiatric disorders (OR 4.4, 95%) compared with women without SSI, receiving Five-fold increased likelihood of blood transfusion (Kvalvik, et al, 2021).…”

Section: Discussionmentioning

confidence: 89%

Risk Factors of Blood Transfusion During Cesarean Section

Zhang

2022

Preprint

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Backgroud: this work was to explore the risk factors of postpartum hemorrhage among puerperae in XX Hospital, and to analyze the influence of high risk factors of postpartum hemorrhage. Methods: the electronic medical record system was adopted to include 220 cases, and 78 puerperae were screened into the blood transfusion group. The clinical indicators of puerperae were analyzed, and the preoperative liver function and renal function were analyzed. The indexes of blood coagulation status and blood routine indexes of puerperae after blood transfusion before blood transfusion were analyzed. Risk factors for blood transfusion during cesarean section were analyzed using a machine learning model. Results: prenatal examination and diagnosis showed that the abnormal placenta accounted for 28.21%; the abnormal amniotic fluid accounted for 7.69%; the umbilical cord around neck accounted for 21.79%; threatened premature birth accounted for 24.36%; scarred uterus accounted for 24.36%; preeclampsia accounted for 20.52%; and anemia accounted for 30.77%. The mean prenatal ALT of liver function index was 20.21, the mean value of AST was 21.29. The mean value of blood urea of renal function index was 4.59, and the mean value of serum creatinine was 46.27. The indexes of blood coagulation status after blood transfusion, RBC, Hct, Plt, PT, APTT, Fbg, and D-D, were significantly different from those before blood transfusion (P < 0.05). The blood routine before blood transfusion indicated that Hb, RBC, and Hct were significantly different from those after blood transfusion (P < 0.05). Conclusion: risk factors of blood transfusion during cesarean section included placenta accreta, placental abruption, placental adhesion, polyhydramnios, pregnancy-induced hypertension, uterine atony, uterine fibroids, cesarean section, and dangerous placenta previa. Risk factors for blood transfusion during cesarean section may gradually decrease with increasing gestational age.

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“…2 In addition, hematocrit tests should be performed. 3 A systematic review of anemia in pregnant women showed that moderate anemia increases the risk of low-birth-weight infants. 4 Furthermore, a comparison of gestational weeks revealed that the anemia group delivered 1 week earlier than the healthy group.…”

Section: Introductionmentioning

confidence: 99%

“…The British Committee for Standards in Haematology recommends that hemoglobin concentration should be routinely measured at antenatal care appointments and at around 28 weeks’ gestation 2 . In addition, hematocrit tests should be performed 3 …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of non-pharmacological interventions to prevent anemia in pregnant women: a quantitative systematic review protocol

Jin,

Shimizu,

Sugiura

et al. 2023

JBI Evidence Synthesis

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Objective: This review aims to identify the effectiveness of non-pharmacological interventions in preventing iron deficiency anemia in pregnant women with a normal course of pregnancy. Introduction: The global prevalence of anemia among pregnant women is 36.5%, posing risks to women and fetuses. This underscores the need for effective prevention; however, the effectiveness of non-pharmacological approaches in preventing pregnancy anemia remains unclear. Inclusion criteria: This review will encompass experimental and quasi-experimental studies on the following approaches to prevent anemia during pregnancy: recommendations for dietary supplements, oral iron supplements (over the counter), provision of supplements to promote iron absorption, participation in anemia prevention education, and provision of information. There will be no restrictions on the duration or frequency of intervention, and longitudinal intervention studies will be included. In studies with a control group, the comparator may be usual care or pharmacological interventions; in studies without, it may involve no intervention, temporal comparisons, or baseline periods without non-pharmacological interventions. Evaluation of hemoglobin, hematocrit, and ferritin will be included as primary outcomes. Low birth weight, preterm birth, amount of blood loss at delivery, small for gestational age, and Apgar scores will be included as secondary outcomes. Methods: A search will be conducted of MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), Scopus, Australian New Zealand Clinical Trials Registry, Cochrane Central Register of Controlled Trials, and ICHUSHI-Web. Researchers will screen studies, extract data, assess the quality of studies, and analyze the data in accordance with the JBI guidance for systematic reviews of effectiveness. GRADE will be used to assess the certainty of the findings. Review registration number: PROSPERO CRD42022344155

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Risk factors for blood transfusion in Cesarean section: A systematic review and meta-analysis

Cited by 7 publications

References 30 publications

A retrospective pilot study examining inhalation anesthesia after delivery on intraoperative blood loss in emergency cesarean section

A retrospective pilot study examining inhalation anesthesia after delivery on intraoperative blood loss in emergency cesarean section

Risk Factors of Blood Transfusion During Cesarean Section

Effectiveness of non-pharmacological interventions to prevent anemia in pregnant women: a quantitative systematic review protocol

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