A Survey on Comparison Between Blood Loss During Cesarean Section with Use of Calculation Method and Visual Estimation

Abstract

Abstract Context: Cesarean section (CS) is a life-saving alternative to vaginal delivery in several maternity units globally and is a risk factor for postpartum hemorrhage (PPH). Its rate has increased globally with wide variability amongst and within various countries. Aim: The aim of the study was to compare blood loss with the calculation method and visual estimation during a CS. Materials and Method: A randomized, double-blind, two-center study of 130 consenting pregnant women who were scheduled for either elective or emergency Lower segment caesarean section (LSCS) at the Institute of Maternal and Child Health, Lagos State University Teaching Hospital (LASUTH) and the Federal Medical Center, Ebute-Metta (FMCEB), Lagos. Data Analysis: Data were imported into Stata version 17 (StataCorp, USA) software for analysis. Student’s t-test or Mann-Whitney U test was utilized to compare continuous variables such as age and estimated blood loss among the tranexamic and placebo groups. Result: The mean age of the participants was 30.8 ± 4.76 years, and about 16% of the participants were nulliparous. There was a statistically significant difference in the calculated estimated blood loss between the intervention and the placebo arm of the study (P value < 0.0001). The mean postoperative blood loss was about 347 ml higher among the placebo group as compared to the intervention (tranexamic acid) group (835.61 ± 400.03 ml vs. 488.12 ± 289.90 ml). Conclusion: Prophylactic use of intravenous tranexamic acid as an adjunct to uterotonic at CS is efficacious in the optimal estimation of blood loss and prevention of post-partum hemorrhage.