Cesarean section intraoperative blood loss and mode of placental separation
| Autor: | H. Ramadani |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
medicine.medical_specialty Blood transfusion Placenta medicine.medical_treatment Population Blood Loss Surgical Blood volume Pregnancy medicine Humans Prospective Studies education Prospective cohort study education.field_of_study Blood Volume Cesarean Section business.industry Case-control study Obstetrics and Gynecology General Medicine medicine.disease Hemostasis Surgical Surgery Treatment Outcome medicine.anatomical_structure Female Endometritis business |
| Zdroj: | International Journal of Gynecology & Obstetrics. 87:114-118 |
| ISSN: | 0020-7292 |
| DOI: | 10.1016/j.ijgo.2004.07.019 |
| Popis: | Objective To investigate whether manual removal of the placenta is associated with significant blood loss compared with spontaneous separation of the placenta during cesarean delivery. Design A randomized prospective study of 400 women with normal pregnancies undergoing cesarean delivery at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Patients were randomly assigned to the study group, (manual placental removal, n=200) or the control group (spontaneous placental separation, n=200). Operative blood loss was assessed by the volumetric and gravimetric methods. Hemoglobin levels were evaluated the third postoperative day and patient's postoperative complications were recorded. Results The mean±S.D. amount of blood loss associated with manual and spontaneous removal of the placenta was 713±240 and 669±253 ml, respectively. This difference was statistically significant (P=0.04). There was a postoperative decrease in hemoglobin levels in both groups. Preoperative hemoglobin levels were 11.6±3 g/dl in the study group and 11.2±1.1 g/dl in the control group, and the difference was statistically significant (P=0.006). The postoperative hemoglobin levels at day 3 were 9.0±1.2 g/dl in the study group and 9.9±1.2 g/dl in the control group (P=0.003), also a statistically significant difference. The incidence of endometritis, wound infection, and need for blood transfusion was similar in the two groups. Conclusion Manual delivery of the placenta was significantly associated with greater operative blood loss and greater decrease in postoperative hemoglobin levels, but with shorter operative time compared with spontaneous placental separation. No difference in postoperative complications was noted between the groups. |
| Databáze: | OpenAIRE |
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