Do we need routine complete blood count examination post partum?

Abstract

SHIR DAR, EYAL SHEINER, GERSHON HOLCBERG, MIRIAM KATZ, HAIM REUVENI, RONIT YERUSHALMI, ILANA SHOHAMVARDI, Ben-Gurion University Soroka Medical Center, Beer-Sheva, Israel, Soroka University Medical Center, BeerSheva, Israel, Ben-Gurion University of the Negev, Beer-Sheva, Israel, Ben Gurion University, Beer-Sheva, Israel, Soroka University Medical Center, Hematology, Beer-Sheva, Israel, Ben Gurion University, Epidemiology, Beer-Sheva, Israel OBJECTIVE: Routine post partum complete blood count examination (CBC) is customary at several medical centers. The main purpose of the CBC is to estimate delivery blood loss and to identify patients who need blood transfusion. The present study was aimed to determine the necessity of routine post-partum CBC following vaginal delivery. STUDY DESIGN: A retrospective cohort study, including all consecutive patients who received blood transfusion following vaginal delivery between January 2003 and November 2004, was performed. Indications for blood transfusions were reviewed in birth-files, including obstetric risk factors such as post-partum hemorrhage (PPH) and symptoms of anemia. RESULTS: Out of 20694 vaginal deliveries, 0.7% (n=138) received blood transfusions. All patients had at least one risk factor of PPH or symptomatic anemia (see Table; several patients had more than one risk factor). None of these patients received the blood transfusion based on the post partum hemoglobin level alone. CONCLUSION: Routine post-partum CBC is not warranted in order to identify patient requiring blood transfusions, and may represent old practice based on non evidence-base medicine. Post partum CBC should probably be taken as indicated by risk factors or patientś complains. This step will save many unnecessary exams.