Abstract：
OBJECTIVE: The aim of this study was to assess the usefulness of routine hemoglobin testing following elective and urgent cesarean section (CS) in patients without primary postpartum hemorrhage (PPH).
METHODS: This retrospective cohort study included women who underwent vaginal delivery (VD), elective CS, and urgent CS at Carmel Medical Center from 2015 to 2020. Data were extracted from the obstetric database, excluding deliveries with PPH. Demographic and obstetric variables were recorded. Primary outcomes were the need for packed red blood cell transfusion.
RESULTS: A total of 19 446 women were included, with five (0.3%) requiring a blood transfusion in the elective CS group, 27 (0.17%) in the VD group, and eight (0.4%) in the urgent CS group. Urgent CS was associated with a higher risk of blood transfusion, but there was no significant difference between elective CS and VD. Elective CS showed the lowest rates of post-delivery hemoglobin below 7 g/dL 1 (0.1%) compared to VD 16 (0.6%) and urgent CS 13 (0.7%).
CONCLUSIONS: Routine postoperative hemoglobin testing following elective CS in asymptomatic patients without PPH appears unnecessary. This study supports reconsidering routine hemoglobin testing following elective CS, aligning with the goal of optimizing resource utilization while maintaining patient quality.
METHODS: This retrospective cohort study included women who underwent vaginal delivery (VD), elective CS, and urgent CS at Carmel Medical Center from 2015 to 2020. Data were extracted from the obstetric database, excluding deliveries with PPH. Demographic and obstetric variables were recorded. Primary outcomes were the need for packed red blood cell transfusion.
RESULTS: A total of 19 446 women were included, with five (0.3%) requiring a blood transfusion in the elective CS group, 27 (0.17%) in the VD group, and eight (0.4%) in the urgent CS group. Urgent CS was associated with a higher risk of blood transfusion, but there was no significant difference between elective CS and VD. Elective CS showed the lowest rates of post-delivery hemoglobin below 7 g/dL 1 (0.1%) compared to VD 16 (0.6%) and urgent CS 13 (0.7%).
CONCLUSIONS: Routine postoperative hemoglobin testing following elective CS in asymptomatic patients without PPH appears unnecessary. This study supports reconsidering routine hemoglobin testing following elective CS, aligning with the goal of optimizing resource utilization while maintaining patient quality.
摘要：
目的：本研究的目的是评估选择性和紧急剖宫产（CS）后常规血红蛋白检测对无原发性产后出血（PPH）患者的有效性。
方法：这项回顾性队列研究包括接受阴道分娩（VD）的女性，选修CS，2015年至2020年在卡梅尔医疗中心紧急CS。数据是从产科数据库中提取的，不包括PPH交付。记录人口统计学和产科变量。主要结果是需要输注充血红细胞。
结果：共纳入19446名妇女，选择性CS组有5人(0.3%)需要输血，VD组27人(0.17%)，紧急CS组中有8名（0.4％）。紧急CS与输血风险较高有关，但选择性CS和VD之间没有显着差异。与VD16（0.6％）和紧急CS13（0.7％）相比，选择性CS显示分娩后血红蛋白低于7g/dL1（0.1％）的发生率最低。
结论：在无PPH的无症状患者中，选择性CS后进行常规术后血红蛋白检测似乎是不必要的。这项研究支持重新考虑选择性CS后的常规血红蛋白测试，与优化资源利用同时保持患者质量的目标保持一致。
方法：这项回顾性队列研究包括接受阴道分娩（VD）的女性，选修CS，2015年至2020年在卡梅尔医疗中心紧急CS。数据是从产科数据库中提取的，不包括PPH交付。记录人口统计学和产科变量。主要结果是需要输注充血红细胞。
结果：共纳入19446名妇女，选择性CS组有5人(0.3%)需要输血，VD组27人(0.17%)，紧急CS组中有8名（0.4％）。紧急CS与输血风险较高有关，但选择性CS和VD之间没有显着差异。与VD16（0.6％）和紧急CS13（0.7％）相比，选择性CS显示分娩后血红蛋白低于7g/dL1（0.1％）的发生率最低。
结论：在无PPH的无症状患者中，选择性CS后进行常规术后血红蛋白检测似乎是不必要的。这项研究支持重新考虑选择性CS后的常规血红蛋白测试，与优化资源利用同时保持患者质量的目标保持一致。
