Comparison Of Postpartum Hemoglobin Decrease Levels In Patients Who Had Normal Vaginal Delivery Versus Cesarean Section
Abstract
Introduction: Cesarean section is an operation that carries a higher risk compared to normal vaginal delivery in terms of bleeding. In this study, we aimed to compare hemoglobin decreases in pregnant women who had normal vaginal delivery and cesarean section.
Material and methods: In this study, pregnant women who had normal vaginal delivery and cesarean section between 01.01.2021 and 30.06.2022 in a university hospital were analyzed retrospectively. The pregnant women included in the study were standardized as those between the ages of 18-45, who did not have any systemic disease, and who gave birth to a baby between 2000-4000 gr at 37-41 weeks of gestation. The patients included in the study were divided into two groups as those who had normal vaginal delivery and cesarean section, and those who delivered by cesarean section were divided into two groups as primary cesarean section and previous cesarean section, and the decreases in hemoglobin levels taken before and at the 6th hour after delivery were statistically evaluated.
Results: It was determined that 199 of the 473 pregnant women included in the study had normal delivery and 274 had a cesarean section (119 had a previous cesarean section and 155 had a primary cesarean section). Among the pregnant women included in the study, the mean postpartum Hb decrease was 0.73 ± 0.90 g/dl in the pregnant women who had normal delivery, and 1.41 ± 0.93 g/dl in those who delivered by cesarean section, the difference was found to be statistically significant (p=0.000). The mean postpartum Hb decrease in those who underwent cesarean section with a previous cesarean indication was 1.30 ± 0.73 g/dl, and 1.49 ±0.9 g/dl in primary cesarean sections, the difference was statistically significant (p=0.045).
Conclusion: With these results determined in accordance with the literature, it would be appropriate to take the necessary precautions by taking these findings into account when making a cesarean section decision.
Keywords
Kaynakça
- Rath WH. Postpartum hemorrhage--update on problems of definitions and diagnosis. Acta Obstet Gynecol Scand. 2011;90(5):421-28. doi:10.1111/j.1600-0412.2011.01107.
- GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [published correction appears in Lancet. 2019 Jun 22;393(10190):e44]. Lancet. 2018;392(10159):1789-1858. doi:10.1016/S0140-6736(18)32279-
- Şencan İ, Üstün YE, Sanisoğlu S, Özcan A, Karaahmetoğlu S, Keskin HL, et al. 2014 Yılı Türkiye Ulusal Anne Ölümlerinin Demografik Verilere Göre Değerlendirilmesi. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2016;13(2), 45-47.
- Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016;11(2):e0148343. Published 2016 Feb 5. doi:10.1371/journal.pone.0148343
- Antoine C. Young B. Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of Perinatal Medicine, 2021;49(1), 5-16. https://doi.org/10.1515/jpm-2020-0305
- Conner SN, Tuuli MG, Colvin R, Shanks AL, Macones GA, Cahill AG. Accuracy of Estimated Blood Loss in Predicting Need for Transfusion after Delivery. Am J Perinatol. 2015;32(13):1225-230. doi:10.1055/s-0035-1552940
- Nagy S, Papp Z. Global approach of the cesarean section rates. Journal of Perinatal Medicine, 2021;49(1), 1-4. https://doi.org/10.1515/jpm-2020-0463
- Karaalp E, Yücel N, Öğütçüoğlu B, Örgül G, Kavak H, Karaalp E. İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma Hastanesi 2011 yılı doğumlarının doğum öncesi ve sonrası hemoglobin-hematokrit değerlerinin karşılaştırılması ve anemi insidansı. Medeniyet Med J. 2013;28: 79-82.
- Cebesoy FB, Balat Ö, Kutlar İ, Dikensoy E. Sezaryen sonrası postpartum kanama neden ve sonuçların analizi. Gaziantep Tıp Dergisi, 2008;14: 15-7.
- Atılgan AE, Acar A, Kılıç F. Postpartum Kanamalı Hastalarda Uygulanan Cerrahi Tekniklerin Retrospektif Analizi. Fırat Tıp Dergisi, 2021;26(1): 37-42.