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ORIGINAL ARTICLE
Year : 2013  |  Volume : 2  |  Issue : 4  |  Page : 255-260

Emergency cesarean section and blood transfusions in patients with severe anemia-Our experience


1 Department of Anaesthesiology, Government Medical College and Government General Hospital, Anantapur, India
2 Department of Anaesthesiology, Osmania Medical College and Government Maternity Hospital, Hyderabad, Andhra Pradesh, India

Correspondence Address:
Kalavala Lakshminarayana Subramanyam
# 202, Rajahamsa Rainbow Apartments Aravindnagar 1st Cross, Anantapur - 515 001,Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.122161

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Introduction: Anemia in pregnancy is a ubiquitous problem, more so in the developing countries. Many of the changes that accompany blood loss appear later, rather than sooner, because obstetric patients are usually young fit adults with an expanded blood volume. In such cases, the needs for blood transfusions mainly depend on the clinical condition rather than the preoperative value of the hemoglobin (Hb) and blood loss. This is usually due to the tolerance of these chronic anemia patients to the accompanying blood loss. Aim: This study was aimed to see how frequently the patients actually received blood perioperatively. Material and Methods: This was a retrospective analysis of patients who underwent emergency cesarean sections. A total of 303 patients underwent emergency cesareans with Hb <8.5 g% over a period of 18 months in our hospital. These patients divided into three groups based on Hb status, Group I <7 g%, Group II 7-8 g%, and Group III >8 g%. Patients in each group were studied regarding the perioperative blood transfusion, any multiple units received, and complications encountered Results: In Group I, blood transfusion done in 88% cases fell drastically to 30% in Group II and 20% in Group III. No significant complications were noted and all patients were discharged without any morbidity. Conclusions: The lower cutoff value of Hb level for an emergency surgery remains a big enigma, which needs further evaluation. Clinical judgment in conjunction with the monitoring of tissue oxygen delivery determines the individual patient's transfusion trigger, and not the use of categorical magic number. Parturient women tend to have lower hematocrit values due to physiological changes and dilutional effect, but they still can tolerate this chronic anemia without any ill effects. This may be one of the reasons for the reduced need for blood transfusion in our study and also for the successful outcome in spite of severe anemia.


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