122 Effect of preoperative thrombocytopenia on blood transfusion after cesarean deliveries

Abstract

Thrombocytopenia at time of delivery is considered to be a risk factor for postpartum hemorrhage. However, platelet count thresholds for postpartum hemorrhage are variable and not extensively studied. We sought to assess if thrombocytopenia is associated with an increased risk of postpartum hemorrhage among women undergoing cesarean delivery. This was a retrospective cohort study of all women who delivered via cesarean delivery at a tertiary referral hospital from January 2012 to June 2018. Women with normal platelet counts (≥150 k/microL) were compared to women with mild thrombocytopenia (100 – 149 k/microL) and women with severe thrombocytopenia (<100 k/microL). Women who received preoperative platelet transfusion were excluded. The primary outcome was red blood cell transfusion. We also examined postpartum hemorrhage (blood loss ≥1000 mL), wound complications (surgical site infections, dehiscence, hematoma), and postpartum emergency department visit. Adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) were calculated, controlling for gestational age, body mass index (kg/m2), scheduled cesarean, and hypertension. We evaluated 7, 177 women who underwent cesarean delivery, of whom 6,431 (89.6%) had normal platelet levels, 675 (9.4%) had mild thrombocytopenia, and 71 (1.0%) had severe thrombocytopenia. Demographics are presented in Table 1. Compared to women with a normal platelet count, women with mild and severe thrombocytopenia did not have increased odds of red blood cell transfusion (normal 5.4%; mild thrombocytopenia 6.4% [aOR 1.16; 95%CI 0.83-1.62]; severe thrombocytopenia 12.7% [aOR 1.44; 95%CI 0.65-3.18]). Similarly, compared to women with a normal platelet count, women with mild and severe thrombocytopenia did not have increased odds of secondary outcomes (Table 2). Preoperative mild and severe thrombocytopenia is not associated with blood transfusion, postpartum hemorrhage, wound complications, and postpartum emergency department visit in women undergoing cesarean delivery.View Large Image Figure ViewerDownload Hi-res image Download (PPT)