title: Do asymptomatic patients require routine hemoglobin testing following uneventful, unplanned cesarean sections?
abstract: OBJECTIVE
  To determine the clinical usefulness of routine postoperative hemoglobin testing after unplanned, uneventful cesarean sections in low-risk women without any signs or symptoms of anemia and to identify possible risk factors for hemorrhage.
  
  
  METHODS
  Retrospective analysis of the charts of all women who underwent non-elective and uneventful cesarean section over 12 months was performed and demographic data, estimated blood loss at surgery, pre- and post-operative hemoglobin values, postoperative symptoms suggesting anemia, and incidence of transfusion were tabulated. Statistical analysis was done with Student t test and Mann-Whitney U test.
  
  
  RESULTS
  A total of 2,450 women were delivered during the study period among whom 743 of them (30.3%) underwent cesarean section. Among the cesarean sections, 421 (56.6%) were found to be unplanned and uneventful operations performed in low-risk women with no postoperative signs or symptoms for anemia. The mean preoperative hemoglobin of the low-risk asymptomatic women was 11.7+/-1.99 g/dl, whereas it was 11.24+/-1.99 g/dl, postoperatively (P<0.001). In 72% of the patients, there was a drop in hemoglobin concentrations, whereas 24.5% experienced an increase and 3.5% showed no change, postoperatively. Only one woman experienced a drop of greater than 30% in hemoglobin concentration. Since the woman did not show any signs of hemodynamic instability or symptoms of anemia, she was not transfused.
  
  
  CONCLUSIONS
  Our findings suggest that routine hemoglobin testing following uneventful, unplanned cesarean section neither change postoperative management nor determine the patients requiring blood transfusion.
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Lutfi Kirdar Kartal Teaching and Research Hospital, Istanbul, Turkey. olusapi506@hotmail.com
authors.forename: Olus
authors.initials: O
authors.lastname: Api
authors.forename: Orhan
authors.initials: O
authors.lastname: Unal
authors.forename: Murat
authors.initials: M
authors.lastname: Api
authors.forename: Ugur
authors.initials: U
authors.lastname: Dogance
authors.forename: Orhan
authors.initials: O
authors.lastname: Balcik
authors.forename: Ozcan
authors.initials: O
authors.lastname: Kara
authors.forename: Cem
authors.initials: C
authors.lastname: Turan
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000175:diagnosis*; D002585:Cesarean Section; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D006454:Hemoglobins