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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2013, Number 05

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Ginecol Obstet Mex 2013; 81 (05)

Factors related to hemorrhage during cesarean section

Rosales AE
Full text How to cite this article

Language: Spanish
References: 11
Page: 239-244
PDF size: 407.79 Kb.


Key words:

bleeding, hemoglobin, hematocrit, cesarean section.

ABSTRACT

Background: Cesarean section is the most frequent surgery done at health sector hospitals and its most frequent complications include hemorrhage.
Objectives: To determine if risk factors known for this complication are really a risk and to determine the reliability of the measurement of hematocrit and hemoglobin as parameters to quantify the hemorrhage.
Material and methods: A prospective study involving 412 patients was done analyzing the following variables: age, previous cesarean section, occupation, body mass index, hours of labor, weight of the newborn, surgical time, bleeding estimated by the anesthesiologist, hemoglobin and hematocrit.
Results: By measuring hemoglobin a significant difference was obtained in favor of minor bleeding in the groups of 21 to 30 years, with normal weight and moderate obesity, with two prior cesarean sections, weight of the newborns of 3 to 4 kg, with less than two hours of labor, when the surgery took less than 50 minutes and when the bleeding was estimated at less than 500 mL. By measuring hematocrit the difference was significant in favor of more bleeding in the following groups: from 31 to 40 years, with mild obesity, without none or one cesarean section, with weight of newborns from 3 to 4 kg, with three to six hours of labor, when the cesarean section took 41 to 50 minutes and when the bleeding was estimated at less than 500 mL.
Conclusions: There are significant differences with the measurement of hemoglobin and hematocrit among the risk factors analyzed.


REFERENCES

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  2. American College of Obstetricians and Gynecologists. Practice Bulletin N° 76: Postpartum Hemorrhage. Obstet Gynecol 2006;108:1039-1048.

  3. Dildy GA. Hemorragia posparto: nuevas opciones terapéuticas. En: Urgencias Obstétricas. México: McGraw-Hill Interamericana, 2002; 45:319-332.

  4. Cherry WB. Complicaciones del 3° y 4° estadios del parto. En: Iffy L, Kaminetzky HA, editores. Obstetricia y Perinatología, Principios y Práctica. Buenos Aires: Panamericana, 1985;984-993.

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  6. Oyelese Y, Scorza WE, Mastrolia R, Smulian JC. Postpartum hemorrhage. Obstet Gynecol Clin North Am 2007;34:421-441.

  7. Schorn MN. Measurement of blood loss: review of the literature. J Midwifery Womens Health 2010;55:20-27.

  8. Razvi K, Chua S, Arulkumaran S, Ratnam SS. A comparison between visual estimation and laboratory determination of blood loss during the third stage of labor. Aust N Z J Obstet Gynaecol 1996;36:152-154.

  9. Patel A, Goudar SS, Geller SR, Kodkany BS, et al. Drape estimation vs. visual assessment for estimating postpartum hemorrhage. Int J Gynaecol Obstet 2006;93:220-224.

  10. Cunningham FG, et al. In: Williams obstetrics. 22th ed. Nueva York: McGraw-Hill Professional, 2005;1145.

  11. Rouse DJ, MacPherson C, Landon M, Varner MW, et al. Blood transfusion and cesarean delivery. Obstet Gynecol 2006;108:891-897.




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Ginecol Obstet Mex. 2013;81