Tariq Mahmood, Amera Tariq, Saleem Ahmed, Aamer Mahmood Malak.
Preoperative blood transfusion, is it essential to arrange blood for patients undergoing caesarean section?.
Pak Armed Forces Med J Jan ;66(1):113-6.

Objective: To assess the need of blood for the patients undergoing caesarean section. Place and Duration of Study: This retrospective study was conducted in Combined Military Hospital (CMH) Jhelum from December 2011 to November 2012. Material and Methods: A total of 224 Caesarean sections done at CMH Jhelum from Dec 2011 to Nov 2012 having American Society of Anaesthesiology (ASA) I and ASA II were included in the study. Patients, who met the preset inclusion criteria i.e. age 20 to 40 years, ASA I / ASA II, primigraveda, previous one, two or three C- sections emergency/ electives were included in the study. Patients with deranged coagulation profile, bleeding disorders, active bleeding (placenta praevia, abruptio placentae) and patients on anticoagulants were excluded from the study. One unit of blood was arranged for patient having hemoglobin (Hb) > 10gm/dl and two units for patient having Hb less than 10gm/dl. Blood was transfused when loss was above 20%, and intravenous fluids given when loss was less than 20%. Results: Out of 224, 181 patients underwent elective C-section and 43 emergency C sections. Emergency surgery was carried out in case of failed induction, cord prolapse, previous C-section in labour and fetal distress. Total 21 patients were considered to receive blood transfusion of which 5 had Hb > 10gm/dl, 5 had Hb between 8-10 gm/dl and 11 patients had HB < 8 gm/dl. Two patients among 11who had Hb less than 8 gm/dl were not given transfusion due to non- availability of blood rest nine received blood. So in fact 19 patients were given blood transfusion.

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