Abstract:
Background: Cesarean delivery is associated with increased risk of hemorrhage, and this
necessitated the practice of routine hematocrit testing to detect anemia and the need for
blood transfusion. Objectives: To ascertain the necessity of this routine investigation and to
identify factors predictive of anemia following uncomplicated cesarean delivery at this clinical
setting. Materials and Methods: A prospective observational study of 236 women who had
uneventful cesarean delivery at term over a 12-month period. Relevant sociodemographic and
obstetric data were extracted, and clinical assessment of the women including postoperative
hematocrit was done on second postoperative day. Data were analyzed using SPSS version
16 for Windows. Multivariate logistic regression analysis was done to identify independent risk
factors predictive of anemia postcesarean section. Results: Average age and parity of the
women were 29.8 ± 4.9 years and 2.2 ± 1.5 respectively. Mean pre and postcesarean hematocrit
was 35.2% ± 3.4% and 30.7% ± 4.0% respectively with an average drop of 4.6% ± 3.3%. Only
5.9% had hematocrit decline of >10% and none was transfused. Preoperative hematocrit
≤35% (P < 0.0001, OR: 4.43, 95% confidence intervals (CI): 2.00-9.80), fatigue (P = 0.04, OR:
3.92, 95% CI: 1.07-14.39), and conjunctival pallor (P = 0.02, OR: 5.01, 95% CI: 1.32-19.02)
were independent factors predictive of anemia postcesarean delivery. Conclusion: This study
suggests that routine postcesarean hematocrit testing is unnecessary following uncomplicated
procedure but may be indicated in women with preoperative hematocrit ≤35%, postoperative
fatigue, and conjunctival pallor.
