Postoperative Hemoglobin Values Research Articles

Retrospective Analysis of the Efficacy and Safety of Benign Gynecological Laparoscopic Surgery in Patients with a History of Open Abdominal Surgery

Objective : In our clinic, we aim to analyze the operative characteristics and complications of patients who have undergone abdomen surgery prior to total laparoscopic hysterectomy, in comparison to those who have not. Materials and Methods: The study analyzed a total of 2012 cases of laparoscopic hysterectomy conducted at the Women's Diseases and Birth Clinic in Tepecik Training and Research Hospital from January 2021 to December 235. The cases were categorized based on whether the patients had previous abdominal surgery or not. Various demographic characteristics, surgical treatment methods, operation durations, indications for hysterectomy, and postoperative findings were documented. Statistical analysis was performed using the SPSS program, with a significance level set at P < 0.05. Findings :No significant differences were found between the two groups in terms of age, body mass index (BMI), preoperative and postoperative hemoglobin (Hb) values and values. In contrast, the difference between preop and post op Hb value measurements ; the level of statistically significant is higher in the group without obdomen surgery (p=0,001). There is no statistically significant difference between indications in both groups as surgical indication (p=0,043). In the group without western surgery, adhesion was observed to be statistically significantly lower (p=0,001). In the group with abdomen surgery, the presence of adhesions sufficient to require adezyolisis is statistically significant (p

Goldstandard TUR-P: the bigger the volume, the higher the speed, but resected volumes of more than 60g are critical.

According to the European Association of Urology guidelines, the limit for monopolar, transurethral resection (M-TURP) in BPH- therapy is a volume of 80g. However, whether larger prostates can also be resected transurethrally might also depend on the experience of the surgeon and especially the resected volume and speed of the resection. Little is known about the latter, and this paper aims to these factors. This study included 540 patients who received a single-stage M-TURP. Based on the postoperative resection weight, these were divided into four groups: group 1 with 10 to 59.9g, group 2 with 60 to 79.9g, group 3 with 80 to 99.9g, and group 4 with ≥ 100g. We examined patient age, the ASA-score, the IPSS, quality of life, resection weight, time and speed, pre- and postoperative hemoglobin and serum sodium values, complications, and surgeon experience. The mean resection weight was 41.6g, and the mean values for resection time and speed were 61.3min and 0.7g/min, respectively. The resection speed increased significantly with resection weight (from 0.7 to 1.3g/min) as well as with the surgeon's level of experience (from 0.4 to 0.9g/min). The number of serious complications (Clavien-Dindo ≥ IIIb) increased significantly from a resection volume of 59.5g (cut-off value). The resection speed of M-TURP increased significantly with the resection weight and the surgeon's level of experience. Regardless of speed, resection weight of more than 60g might increase the risk of severe complications.

Results of patients who were followed up with special dressings without the use of drains after primary total knee arthroplasty

Objective: This study aimed to compare the clinical and functional results of patients who used drains with those who used compressive dressings without drains after tourniquetless total knee arthroplasty (TKA) for primary gonarthrosis. Methods: Between January 2019 and June 2023, 316 patients who underwent total knee replacements were evaluated retrospectively. After excluding patients who used tourniquets, 120 patients who met the inclusion criteria were included in the study. Postoperative hemoglobin changes, early–late postoperative edema, pain, range of motion (ROM), clinical scores, and functional outcomes were evaluated and compared in 68 patients (18 males and 50 females) and 52 patients (11 males and 41 females). Results: There was no significant difference in preoperative and postoperative hemoglobin values, 6th week Knee Society Score (KSS)–knee, and KSS-functional scores between patients with and without drains (p > 0.05). Although there was a statistically significant difference in ROM on the first postoperative day, there was no statistically significant difference in the postoperative second-week ROM. There was a significant difference in Day 1 and 3 visual analog scale (VAS) scores between patients with and without drains (p < 0.001). Conclusion: According to the findings of this study, using a drain after primary TKA is unnecessary. Although the clinical results of patients without a drain after total knee arthroplasty are similar to those with a drain, patients can be treated and followed up with compressive dressings without a drain.

The Impact of Tranexamic Acid Administration on Bleeding in Total Knee Arthroplasty: A Comparative Analysis Based on Anesthetic Techniques

Purpose: This retrospective study focused on examining the effect of local tranexamic use on postoperative bleeding in TKA surgery with general or spinal anaesthesia. Materials and methods: This study analysed the postoperative bleeding amounts in 95 knees with primary osteoarthritis that underwent TKA between January 2017 and 2023. Patients undergoing TKA under general or spinal anaesthesia were separated into four groups based on whether or not local tranexamic acid was given perioperatively. The postoperative hemogram alterations, drainage volume, and transfusion needs of these patients were assessed. Results: Group 4 saw a significantly higher decline in haemoglobin levels within the first twenty-four hours following surgery distinct from groups 1, 2, and 3 (p1:0.001; p2:0.000; p3:0.001, p0.05). Postoperative hemoglobin values in Group 3 were statistically importantly higher than Groups 1,2 and 4 (p1:0.019; p2:0.003; p

Surgical and Histopathological Results in Carotid Body Tumors.

The possible relationships between the histopathological findings of carotid body tumors and age, gender, tumor diameter, and Shamblin classification were investigated. In addition, preoperative embolization status, development of neurological complications, need for vascular reconstruction, hemoglobin change, and discharge time were examined and the effects of these variables on each other were analyzed. Between 2008 and 2022, 46 cases who underwent carotid body tumor excision were examined retrospectively. The cases were followed for an average of 81 months postoperatively. Histopathological materials were reexamined and the effect of categorical variables was analyzed. Mean tumor diameter was 3.55 ± 1.26 cm, mean discharge time was 3.91 ± 2.37 days, and mean hemoglobin change was 1.86 ± 1.25. Neurological complications developed in 13% of cases. The amount of hemoglobin change was significantly (p = 0.003) higher in those who developed neurological complications, whereas the tumor diameter and discharge time were found to be insignificantly higher. Surgical complications requiring vascular repair occurred in 10.8% of cases. Tumor diameter (p = 0.017) and hemoglobin change (p = 0.046) were significantly higher in these patients. There were significant correlations between higher Shamblin classification and tumor diameter, discharge time, postoperative hemoglobin value, and number of surgical and neurological complications. No significant difference was found between Ki-67, capsular invasion, mitosis, pleomorphism, prominent nucleoli, mean island diameter, and tendency of islands to merge with categorical variables. As the tumor diameter increases, the operation becomes more difficult and the postoperative complication rate increases. We think that subadventitial and capsular removal of the tumor is effective in preventing recurrence. To reach a histopathological conclusion, a larger series of studies including tumors with high Ki-67 and mitosis rates, large size, and one or more of the criteria for necrosis are needed.

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy

The objective of this article is to compare the amount of intraoperative blood loss during laparoscopic myomectomy when performing bilateral transient clamping of the uterine and utero-ovarian arteries versus no intervention. It´s a randomized controlled prospective study carried out in the Department of Obstetrics and Gynecology Ramón y Cajal University Hospital and HM Montepríncipe-Sanchinarro University Hospital, Madrid, Spain, in women with fibroid uterus undergoing laparoscopic myomectomy. Eighty women diagnosed with symptomatic fibroid uterus were randomly assigned to undergo laparoscopic myomectomy without additional intervention (Group A) or temporary clamping of bilateral uterine and utero-ovarian arteries prior to laparoscopic myomectomy (Group B). Estimated blood loss, operating time, length of hospital stay, and postoperative hemoglobin values were compared in both groups. The number of fibroids removed was similar in both groups (p = 0.77). Estimated blood loss was lower in the group of patients with prior occlusion of uterine arteries (p = 0.025) without increasing operating time (p = 0.17) nor length of stay (p = 0.17). No patient had either intra or postoperative complications. Only two patients (2.5%) required blood transfusion after surgery. We conclude that temporary clamping of bilateral uterine arteries prior to laparoscopic myomectomy is a safe intervention that reduces blood loss without increasing operative time.

Vaginal Hysterectomy at the Time of Total Colpocleisis: A Single-Center Experience.

This study aims to evaluate the five-yearexperience of a single centerregarding the total colpocleisis procedure. This is a retrospective review of 24 women who underwent total colpocleisis at the study center between January 2017 and January 2023. Every participant was informed about this study, and written consent was obtained from each participant who then took Pelvic Floor Distress Inventory-20 (PFDI-20), Body Appreciation Scale-2 (BAS-2) and Decision Regret Scale (DRS) questionnaires consecutively. Eight patients (33.3%) underwent total colpocleisis, whereas 16 patients (66.7%) had concomitant colpocleisis and vaginal hysterectomy. The number of total colpocleisis cases did not change significantly with respect to the past years (p=0.117). The patients who underwent total colpocleisis and the patients who had concurrent colpocleisis and hysterectomy were statistically similar with respect to age, gravidity, chronic disease, blood group, American Society of Anesthesiologists classification, anesthesia type, surgery timing and preoperative and postoperative hemoglobin values (p>0.05 for all). Operative time was significantly shorter in patients who had colpocleisis alone (p=0.001). Both patient groups were also statistically similar in aspects of blood loss, transfusion need, hospital stay, postoperative complications and follow-up time as well as PFDI-20, BAS-2 and DRS scores (p>0.05 for all). Endometrial atrophy (56.3%), endometrial hyperplasia (18.8%) and adenomyosis (12.5%) were the most common histopathological findings detected in vaginal hysterectomy specimens. The combination of vaginal hysterectomy and total colpocleisis appears as a safe and efficient approach which does not contribute to the surgery-related morbidity despite the significantly longer operative time.

Association of sex and aspirin use with postoperative bleeding in patients with lower extremity long bone fractures

ObjectiveThe perioperative management of patients on antiplatelet drugs is a rising challenge in orthopedic trauma because antiplatelet drugs are frequently encountered and carry an increased risk of hemorrhagic consequences. The...

The “Medical Cost” of Robot-Assisted Laparoscopic Surgery in Endometrial Cancer in Terms of Anesthesia Comparison with Traditional Laparoscopic Surgery

Objective :Minimally invasive surgeries have important advantages such as lower morbidity, shorter hospital stay, and earlier return to routine life. Robot-assisted laparoscopic surgery (RALS) plays a leading role in the development process of minimally invasive surgery. In this study, we compared patients with endometrial cancer who were operated with RALS and traditional laparoscopic surgery (TLS) methods in terms of processes related to anesthesia, such as peroperative fluid management and transfusion requirement, analgesic strategies, postoperative complications, duration of post-anesthesia care unit (PACU) and hospital stay
 Materials and Methods: Patients with American Society of Anaesthesiologists (ASA) scores II-III, over the age of 18, who were operated for endometrial cancer by TLS or RALS methods between January 2020 and March 2022 were included in the study. Patients age, ASA score, duration of surgery, peroperative fluid management, transfusion requirement, urine output, bleeding, postoperative Visual Analogue Scale (VAS) scores, the PACU admission were obtained from the standard anesthesia record form and preoperative and postoperative hemoglobin (Hb) values, length of hospital stay were obtained from the electronic database of the hospital. 
 Results: Intravenous fluid input, bleeding and urine output during the operation were statistically lower in group RALS. While there was no difference between the preoperative Hb values of the two groups, the postoperative Hb values were significantly lower in the TLS group. Perioperative bleeding and fluid replacement are lesser and the hospital stay is shorter in RALS. 
 Conclusion: TLS and RALS, which are minimally invasive surgical methods, are used in the treatment of endometrial cancer. The idea that RALS is more costly than TLS should be reconsidered, as RALS reduces costs with less perioperative bleeding and fluid replacement and shorter hospital stay

Associations of preoperative anemia and postoperative hemoglobin values with hospital costs in total knee arthroplasty (TKA)

BackgroundTotal knee arthroplasty are among the most frequently conducted surgeries, due to an aging society. Since hospital costs are subsequently rising, adequate preparation of patients and reimbursement becomes more and more important. Recent literature revealed anemia as a risk factor for enhanced length of stay (LOS) and complications. This study analyzed whether preoperative hemoglobin (Hb) and postoperative Hb were associated with total hospital costs and general ward costs.MethodsThe study comprised 367 patients from a single high-volume hospital in Germany. Hospital costs were calculated with standardized cost accounting methods. Generalized linear models were applied to account for confounders, such as age, comorbidities, body mass index, insurance status, health-related quality of life, implant types, incision-suture-time and tranexamic acid.ResultsPreoperative anemic women had 426 Euros higher general ward costs (p < 0.01), due to increased LOS. For men, 1 g/dl less Hb loss between the preoperative value and the value before discharge reduced total costs by 292 Euros (p < 0.001) and 161 Euros fewer general ward costs (p < 0.001). Total hospital costs were reduced by 144 Euros with 1 g/dl higher Hb on day 2 postoperatively for women (p < 0.01).ConclusionPreoperative anemia was associated with increased general ward costs for women and Hb loss with decreasing total hospital costs for men and women. Cost containment, especially reduced utilization of the general ward, may be feasible with the correction of anemia for women. Postoperative Hb values may be a factor for adjustments of reimbursement systems.Level of evidenceRetrospective cohort study, III.

Correlation Between Initial Postoperative Hemoglobin Value and Prognosis in Non-Cardiac Surgery Patients Receiving Intraoperative Blood Transfusion

To analyze the relationship between initial (within 24 hours) postoperative hemoglobin (Hb) value and prognosis in non-cardiac surgery patients receiving intraoperative blood transfusion, and to provide support for sensible blood use in surgery. A retrospective analysis was performed on all patients aged 18 or older who underwent non-cardiac surgeries and who received intraoperative blood transfusion at West China Hospital, Sichuan University from 2012 to 2018. According to their initial postoperative Hb levels, the patients were divided into 6 groups, including Hb<75 g/L, 75 g/L≤Hb<85 g/L, 85 g/L≤Hb<95 g/L, 95 g/L≤Hb<105 g/L, 105 g/L≤Hb<115 g/L, and Hb≥115 g/L goups. Multivariate linear regression was performed to examine the differences in the length-of-stay between the groups and binary logistic regression analysis was conducted to examine the differences between the groups in inpatient mortality, the rate of patient voluntary discharge against medical advice, incidence of acute ischemic injury, including acute kidney injury, myocardial infarction, and cerebral infarction, and length-of-stay longer than 28 days. In addition, the effects of multiple interactions between initial postoperative Hb and the types of surgery, the amount of intraoperative red blood cell infusion (red blood cell<8 U vs. red blood cell≥8 U), and preoperative anemia status (Hb<100 g/L vs. Hb≥100 g/L) on postoperative length-of-stay were analyzed. A total of 7528 patients were included in this study. Compared to those of the reference group, the 95 g/L≤Hb<105 g/L group, the length-of-stay of patients with initial postoperative Hb<75 g/L increased and the mortality (odds ratio [ OR]=2.562) and the rate of voluntary discharge against medical advice ( OR=1.681) increased significantly. Patients in the 75 g/L≤Hb<85 g/L group had increased length-of-stay and increased incidence of acute ischemic injury ( OR=1.778) relative to the reference group. The interaction analysis showed that there was significant interaction between initial postoperative Hb and the types of surgery, which influenced the postoperative length-of-stay. In non-cardiac surgery patients who have receive blood transfusion, initial postoperative Hb<85 g/L is associated with poorer prognosis. However, those patients with higher initial postoperative Hb did not gain more benefits, suggesting that 85 g/L≤Hb<95 g/L may be the target Hb value for sensible intraoperative transfusion.

Comparison of vaginal, abdominal and laparoscopic hysterectomy performed in our hospital

Hysterectomy is the most common pelvic surgical operation and is often performed for benign reasons. We aimed to compare clinical total abdominal hysterectomy (TAH), total laparoscopic hysterectomy (TLH), and vaginal hysterectomy (VH) in benign gynecological conditions. Patients' age, operation duration (min), length of stay in the hospital (days), Preop Hb (g/dL), Postop Hb (g/dL) values, complications according to the performed surgical procedures were analyzed. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications. it was observed that the patients' ages were significantly higher in the VH group (H=71.721; p=0.000), the operation duration was significantly shorter in the TAH group (H=125.689; p=0.000), and the length of hospital stay was significantly shorter in the TLH group (H=71.492; p=0.000). Preoperative and postoperative hemoglobin values were significantly higher in the VH group (H=57.222; p=0.000, H=52.824; p=0.000). It was determined that the complication rate was lower in the TAH group. The type of surgical procedure was found to not have a statistically significant effect on transfusion requirement (χ2=4.852; p&gt;0.05) and history of previous surgery (χ2=0.115; p&gt;0.05). The surgical approach of hysterectomy plays a significant role in postoperative morbidity. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications.

Efficacy of suction curettage as the first-line treatment of cesarean scar pregnancy: A retrospective study

ObjectiveThere is still no consensus on a safe and efficient treatment modality for cesarean scar pregnancy (CSP), which is known to cause severe complications, such as life-threatening hemorrhage. Suction curettage (SC) has been used as the first-line treatment for CSP with controversial outcomes. In this context, the objective of this study is to analyze the efficacy of SC in the treatment of CSP. MethodsThe sample of this retrospective study consisted of 64 CSP patients treated using SC between 2012 and 2022. Patients’ demographic and clinical variables, including the thickness of the myometrium at the lower uterine segment between the urinary bladder and cesarean scar, were obtained from their medical records. The study's primary outcome was determined as the success rate of SC. Accordingly, the patients were categorized into two groups: successful SC (Group 1) and unsuccessful SC (Group 2). Results: The success rate of SC was determined as 78.1%. The number of previous cesarean deliveries, gestational age, baseline beta-human chorionic gonadotropin (β-hCG) values, and endometrial thickness was significantly higher in Group 2 (p<0.05 for all), whereas the fetal cardiac activity and absence of an embryonic pole were significantly higher in Group 2 (p = 0.001 and p = 0.004, respectively). There was no significant difference between the groups in the thickness of the myometrium at the lower uterine segment (p = 0.890). The hemoglobin levels decreased significantly after SC in both Groups 1 and 2 (p<0.001 and p = 0.009, respectively). There was no significant difference between the groups in preoperative and postoperative hemoglobin values and the decrease in hemoglobin levels (p>0.05). ConclusionThe study findings did not indicate any significant correlation between myometrial thickness at the lower uterine segment and the efficacy of SC in CSP patients. On the other hand, the number of cesarean deliveries, gestational age, baseline β-hCG values, endometrium thickness, fetal cardiac activity, and embryonic pole may be used to predict the outcome of SC in the treatment of CSP.

Investigation of clinical efficacy and safety of a new herbal “Algan Hemostatic AgentTM” in lumbar disc herniation operations

Aim. ALGAN Hemostatic Agent (AHA) is obtained with a standard mixture of 6 different herbs. It is a polysaccharide based hemostatic agent. The purpose of this study is to determine the clinical efficacy and reliability of AHA as a local hemostatic agent in lumbar disc herniation operations. Materials and Methods. In the study, the hemostatic efficacy of the product was observed on 28 volunteers underwent lumbar disc herniation surgery. In the treatment and control groups (14 patients each), operation times, bleeding stop times, pre- and postoperative hematocrit values (amount of blood loss), duration of hospital stay, and need for cautery use were compared. Traditional methods (cautery, ligation, etc.), which are used as a hemostatic in the operation, were always ready to be used effectively. The AHA application took 120 seconds. Results. While there was no difference between the groups in terms of preoperative hemoglobin and hematocrit values, postoperative hemoglobin and hematocrit values were statistically significant (p=0.033, 0.043). The amount of cautery use decreased significantly in the treatment group and the result was found to be statistically significant (p=.0.001). There was no significant difference in blood transfusion and mean operation times. Conclusions. AHA has been shown to be both effective in controlling bleeding and safe, so it can be used as an auxiliary product in capillary bleeding control in lumbar disc operations.

Effect of patellar resurfacing surgery on bleeding in total knee arthroplasty.

Postoperative bleeding is one of the most important factors affecting clinical and functional results in total knee arthroplasty. Therefore, many studies have been conducted on bleeding in arthroplasty patients. However, there are very few reports investigating the effect of patellar surface replacement on bleeding in knee arthroplasty. We, therefore, aimed to investigate the effect of patellar surface replacement on postoperative bleeding. In this retrospective study, 30 with patellar resurfacing were compared with 39 without patellar resurfacing among patients who had undergone total knee replacement due to primary osteoarthritis. Demographic data, amount of transfusion, preoperative and postoperative hemoglobin and hematocrit values, and total, visible, and hidden blood loss values were recorded. No statistical difference was found between the two groups in terms of demographic values. There was no significant difference between the groups in terms of the amount of blood in the drain, total blood loss, hidden blood loss, and blood transfusion in patients who had and had not undergone patellar resurfacing. A positive significant correlation was found between postoperative drainage volume and total blood loss. Patellar component application in patients who had undergone total knee arthroplasty does not change the blood loss of the patients.

Use of ureteral catheter in uterine-sparing surgery for placenta accreta

Objective: The study aimed to investigate the effect of ureteral catheter use during surgery on the outcomes of obstetric and urinary complications in patients with placenta accreta spectrum (PAS) and placenta previa. Methods: The patients who were followed up at Meram Medical Faculty Hospital of Necmettin Erbakan University between January 2016 and November 2021 and diagnosed with PAS and placenta previa were included. Patients who underwent emergency and planned surgery were grouped as those with or without an intraoperative ureteral catheter. The primary outcome was determined as the rate of urinary system damage among these groups. The number of blood transfusions, preoperative and postoperative hemoglobin values and hemoglobin changes, length of hospitalization, patients who underwent uterine-sparing surgery or hysterectomy, urinary tract injury, and wound infection were compared regarding the use of catheters. Results: A total of 122 patients were included in the study. While an intraoperative ureteral catheter was placed in 56 (45.01%) patients, it was not used in 66 (54.09%) patients. Bladder injuries were determined in 31 (55.4%) patients with a catheter and 13 (19.7%) patients without a catheter, and no other urinary system injuries were found. The incidence of bladder injury was statistically significantly higher in the group with a catheter (p=0.001). The number of transfused erythrocyte suspensions, the hemoglobin change according to the preoperative hemoglobin level, and the mean duration of hospitalization in patients with a catheter were statistically significantly greater than the group without a catheter (p=0.001). Conclusion: Ureteral catheterization did not reduce urinary damage in patients with PAS and placenta previa who underwent uterine-sparing surgery and hysterectomy. However, we believe that the insertion of a catheter increases the possibility of diagnosing intraoperative damage.

Evaluation of Blood Loss in Conventional vs MAKOplasty Total Knee Arthroplasty

BackgroundPrimary total knee arthroplasty (TKA) has been historically associated with considerable blood loss. Allogenic transfusions, the standard of care for blood loss following TKA, carry inherent risks. With the expanding use of robotic technology in TKA, one theoretical advantage is decreased blood loss and postoperative blood transfusions requirements. The purpose of this study was to compare postoperative hemoglobin levels and the percentage of patients requiring a transfusion of allogenic packed red blood cells after conventional TKA (CTKA) vs robot-assisted TKA (RATKA). MethodsThis is a retrospective review of 486 consecutive patients undergoing either CTKA or RATKA between October 30, 2018, and June 25, 2020, by a single fellowship-trained arthroplasty surgeon. Mako SmartRobotics (Stryker, Kalamazoo, MI) was used for RATKA cases. Primary outcomes included preoperative vs postoperative hemoglobin values and postoperative blood transfusion rates between the 2 groups. ResultsThe mean hemoglobin on postoperative day 1 was 10.7 gm/dl (±1.3) in the CTKA group and 10.9 gm/dl (±1.3) in the RATKA group, P = .24. The largest decline in hemoglobin from preoperative to within 2 days postoperatively was 3.1 gm/dl (±1.1) in the CTKA group and 3.1 gm/dl (±1.1) in the RATKA group, P = .92. The percentage of patients requiring a blood transfusion was 1.1% in the CTKA group and 1.3% in the RATKA group, P = .79. ConclusionsRATKA and CTKA groups did not have significant differences in postoperative hemoglobin changes or the need for postoperative blood transfusions.

The fetal and maternal outcomes related to previous number of cesarean sections and uterus sparing surgery in women with abnormal placentation

Objectives. We aimed to study the number of previous cesarean sections in cases diagnosed with placenta previa (PP) and placenta accreta spectrum (PAS), and maternal and fetal results in cases where we performed uterus-sparing surgery. Materials and Methods. PAS patients diagnosed with PP (PPAS) were included in this retrospective study. Postoperative hemogram values, blood transfusion amounts, hospitalization days, intraoperative and postoperative complication rates of all patients, APGAR scores (5-minute), mortality rates and birth weights were registered for all newborns on admission to the intensive care unit. Results. A total of 122 pregnant women were included in the study. In the comparison of hospitalization rates, there was a significant difference between CS ≤1 and CS =2 (p=0.01). When postoperative hemoglobin values were compared, there was significant difference between CS ≤1 and CS ≥3 (p&lt;0.01). Neonatal intensive care admission rates increase as the number of CS increases. Conclusions. Uterus-sparing surgery in experienced clinics seems to be applicable, even if maternal and fetal morbidity increases. We suggest to consider CS numbers in PPAS group for fetal and maternal wellness while doing surgical planning.

Estimating blood loss during cesarean delivery: A comparison of methods

ObjectivesObstetrical hemorrhage contributes significantly to maternal morbidity and mortality. Assessment of blood loss while undergoing cesarean sections (CS) is essential in lowering the morbidity and mortality, however this amount is commonly underestimated by the surgeon and probably the anesthetist too. MethodsThis study addresses this issue by comparing three separate ways of assessing blood loss during cesarean sections. For each of 97 full-term pregnant women undergoing elective CS, blood loss was measured by the following: visual estimation by both the obstetrician and the anesthetist, weighing surgical pads pre operatively and post operatively and by calculations (multiplying the difference of pre-operative and postoperative hemoglobin values by the patient's estimated blood volume). ResultsThe results of this study indicated that the lowest estimated value for blood loss came from visual estimation, while the highest value came from the mathematical formula. Anesthetists were more accurate in their visual estimation of blood loss than were obstetricians. ConclusionThis study found the amount of blood loss during CS to be overestimated by the mathematical calculation and underestimated by obstetricians. However, the estimate given by anesthetists was close to that obtained by weighing pads. This underscores the need for more accurate methods of blood loss estimation in cesarean sections to be adopted.

The effect of tranexamic acid on hidden blood loss in total hip arthroplasty.

Objectives In this study, we aimed to examine the effect of tranexamic acid (TXA) on hidden blood loss in total hip arthroplasty (THA) patients.Patients and methods Between June 2015 and June 2021, a total of 120 patients (45 males, 75 females; mean age 57.2±4.9 years; range, 45 to 67 years) with primary osteoarthritis who underwent THA without the use of TXA and 53 patients who received TXA were retrospectively analyzed. Demographic data, amount of transfusion, early complications, preoperative and postoperative hemoglobin and hematocrit values, total blood loss, visible blood loss, and hidden blood loss values were compared.Results There was a significant difference between the groups with and without the use of TXA in terms of intraoperative bleeding, amount of blood in the drain, total blood loss, hidden blood loss, and blood transfusion (p<0.05). A significant positive correlation was found between intraoperative blood loss and hidden blood loss (r=0.325 p<0.01), while no significant correlation was found between postoperative drainage volume and hidden blood loss (r=-0.006 p=0.946).Conclusion The use of TXA in patients undergoing THA reduces blood loss, including hidden blood loss, thereby reducing the need for blood transfusion after hip arthroplasty. However, there seems to be no linear relationship between postoperative blood loss and hidden blood loss. Considering these results, the routine use of TXA can be recommended in THA, unless there is a contraindication.