Factors associated with perioperative blood transfusion in women who had postpartum haemorrhage following caesarean delivery

Abstract

Background: Caesarean delivery is associated with intraoperative blood loss and is a common risk factor for blood transfusion in obstetric practice. Delayed diagnosis and management of obstetric haemorrhage contributes greatly to maternal morbidity and mortality, but patient safety can be enhanced by identifying those at risk. Objective: To evaluate postpartum haemorrhage patients at greater risk for perioperative blood transfusion at caesarean delivery. Methods: A retrospective study was conducted over a two-year period from 1st June 2021 to 31st May 2023. The study population were all consecutive women who underwent caesarean delivery after 28 weeks of gestation, diagnosed as having postpartum haemorrhage (estimated blood loss ≥1000 ml). Women were considered as having the primary outcome if they had intraoperative blood transfusion and/or postoperative transfusion within 24 hours. Data were analyzed with SPSS for Windows version 23. Association between variables were determined using the Chi-square test or Fisher’s exact test as appropriate, and a p-value <0.05 was considered significant. Results: Out of the study population, 55.6% had blood transfusion (43/76). These women received a total of 72 pints of whole blood, with 58.1% (25/43) receiving only one pint. There was a significant relationship between blood transfusion and the type of pregnancy, whether singleton or multiple gestation (P=0.032), placenta previa (P=0.002), and abruptio placenta (P=0.033). Conclusion: Among women who underwent caesarean delivery and had postpartum haemorrhage the prevalence of blood transfusion was high, and placenta previa and abruptio placenta were associated factors for perioperative blood transfusion.