Blood Arrangement and Frequency of Blood Transfusion in Women Undergoing Cesarean Section

Abstract

Objective: To determine the frequency of preoperative blood arrangement and actual blood transfusion in women undergoing elective cesarean section.

Methodology: This descriptive cross-sectional study was conducted in Department of Obstetrics and Gynecology, Pakistan Railways Hospital, IIMCT, Rawalpindi, from July 31, 2021, to January 30, 2022. This study included 250 pregnant women of 18-40 years of age having singleton pregnancies at ≥37 weeks of gestation who were scheduled for elective cesarean section and consecutively enrolled after ethical approval and informed consent. Women with antepartum/postpartum hemorrhage, known anemia (Hb < 10 g/dL), bleeding disorders, uterine fibroids, placenta previa/accreta spectrum, or emergency cesarean were excluded. A structured proforma was used to record demographic and obstetric variables, blood reservation (cross-match) status, and transfusion within 24 hours postoperatively. Data were analyzed with SPSS 26; continuous variables were summarized as mean ± SD, and categorical variables were summarized as frequency and percentage. Chi-square test was applied for stratified analysis. p < 0.05 was taken as statistically significant.

Results: The mean age was 30.1 ± 4.6 years, mean BMI 28.4 ± 3.0 kg/m², and mean preoperative Hemoglobin 12.1 ± 0.9 g/dL. Blood was cross-matched in 99 (39.6%) women, while 41 (16.4%) required actual transfusion. Blood transfusion and blood reservation and transfusion were significantly associated with maternal anemia, higher parity and multiple previous cesareans (all p < 0.05).

Conclusion: Preoperative blood ordering substantially exceeded actual transfusion requirements, indicating over‐utilization of blood bank resources. A risk-based blood ordering strategy, incorporating type and screen for low-risk cases and reserving cross-matching for identifiable risk factors, is recommended to optimize resource use without compromising maternal safety.