title: Descriptive study of blood transfusion practices in women undergoing cesarean delivery.
abstract: OBJECTIVE
  To study the blood transfusion practices in women undergoing cesarean delivery at a tertiary care centre in northern India.
  
  
  METHODS
  This was a prospective study conducted in 1769 women who underwent cesarean section at a tertiary centre hospital from May 2008 to November 2009. A comprehensive predesigned proforma was filled in for each woman. Data related to antenatal, intrapartum and postnatal events was recorded and compared between women receiving blood transfusion during cesarean section and women not receiving blood transfusion.
  
  
  RESULTS
  The cesarean section rate was 26% and the blood transfusion rate was 12.21%. The overall crossmatch transfusion ratio in our study was 5.46:1. After multiple regression logistic analysis factors, like placenta previa (OR 15.19, 95% CI 9.28-24.82), anemia (OR 9.93, 95% CI 5.17-19.06), blood loss >1000 mL (OR 5.97, 95% CI 4.32-8.24), abruptio (OR 4.18, 95% CI 2.02-8.62), intraoperative complications, like uterine incision extension, uterine atony, hysterectomy (OR 2.69, 95% CI 1.70-4.24), general anesthesia (2.48, 95% CI 1.70-3.61) and inadequate antenatal supervision (OR 1.59, 95% CI 1.05-2.42) were found to be significantly associated with a higher risk for blood transfusion during cesarean section.
  
  
  CONCLUSIONS
  Routine crossmatching of blood for all women prior to cesarean section needs to be reviewed. Cesarean sections performed on women with high risk factors for blood transfusion can have sudden and significant blood loss and thus adequate blood arrangement prior to cesarean section is justified only in this group of women and not in all women.
authors.affiliation: Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Aditi
authors.initials: A
authors.lastname: Goundan
authors.forename: Jasvinder Kaur
authors.initials: JK
authors.lastname: Kalra
authors.forename: Ainharan
authors.initials: A
authors.lastname: Raveendran
authors.forename: Rashmi
authors.initials: R
authors.lastname: Bagga
authors.forename: Neelam
authors.initials: N
authors.lastname: Aggarwal
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D002585:Cesarean Section; D005260:Female; D006801:Humans; D010923:Placenta Previa / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D014592:Uterine Hemorrhage / Q000628:therapy*