Caesarean section: Intra-operative blood loss and its restitution

Abstract

Objectives: To determine the rate of blood loss and its restitution during Caesarean section and make recommendations to improve our practice. Design: Prospective study. Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from 1st January 2005 to December 2005. Subjects: All term Caesarean sections performed during the period. Results: Six hundred and forty one patients met the inclusion criteria. The mean maternal age was 30.42 years ±5.5 (Range 16-44 years). Fifty seven patients (8.9%) were transfused. Major blood loss (>1000 ml) was reported in 7.6% of the patients. The main causes of major blood loss during surgery were placental disorders and pre-eclampsia. The main indications for transfusion were placental disorders, pre-eclampsia and breech presentation. The packed cell volume, status of the anaesthetist and the ASA grading were other factors, which had statistical association with blood transfusion. The risk of major blood loss and transfusion were negligible in patients presenting for foetal distress, cephalo-pelvic disproportion and breech presentation. Conclusion: The rate of blood transfusion during Caesarian section is high. Antepartum haemorrhage and pre-eclampsia were predictable indications for major blood loss and transfusion. Major blood loss and transfusion rate were negligible in patients presenting with foetal distress, cephalo-pelvic disproportion and breech presentation.