Comment on Olus Api et al.: Do asymptomatic patients require routine hemoglobin testing following uneventful, unplanned cesarean sections?

Abstract

We commend the excellent paper titled “Do asymptomatic patients require routine hemoglobin testing following uneventful, unplanned cesarean sections?” [1]. In our experience, it is important to have a formal, written report stating blood group and hemogram in case a woman require a blood transfusion at any stage during the pregnancy or after the birth, due to excessive bleeding or hemorrhage. I would like to draw the attention of authors that although postpartum hemorrhage (PPH) due to cesarean scar dehiscence is an unusual complication, practitioners should add dehiscence to their diVerential diagnoses [2]. Another rare cause of delayed PPH is uterine artery pseudo-aneurysm [3]. Patients discharged home after cesarean sections in stable condition can visit emergency department due to bleeding. Secondary PPH deWned as excessive uterine bleeding occurring between 24 h and 12 weeks postpartum. The pathogenesis includes diVuse uterine atony or subinvolution of the placental site secondary to retained products of conception and/or infection, but the exact cause is often not known. The possibility of a bleeding diathesis should be considered, especially in women with a history of menorrhagia [4, 5]. These facts should be considered in the postoperative management protocol of both planned or uneventful and unplanned cesarean sections while ordering blood grouping, hemogram and tests for known bleeding tendency.