title: Repeat caesarean delivery as a risk factor for abnormal blood loss, blood transfusion and perinatal mortality.
abstract: We reviewed 450 cases of caesarean delivery (January-December 2009) at the University of Ilorin Teaching Hospital in Nigeria. We analysed the association between caesarean delivery status (primary or previous) and the following outcomes: abnormal blood-loss, blood transfusion and perinatal mortality. Although significant differences were observed between primary and previous caesarean delivery groups in regards to maternal age, urgency of the caesarean delivery, booking status, and cadre of birth attendant staff, no association was noted between caesarean delivery status and any of the three outcomes. Further analyses identified parity as an important predictor for blood transfusion and abnormal blood loss. In addition, we found a dose?response relationship between parity and abnormal blood loss (< 0.05). Also, mothers with an emergency caesarean delivery of the index pregnancy were more than twice as likely to have a blood transfusion as compared with those with an elective caesarean delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Nigeria.
authors.forename: R
authors.initials: R
authors.lastname: Saidu
authors.forename: B O
authors.initials: BO
authors.lastname: Bolaji
authors.forename: A W O
authors.initials: AW
authors.lastname: Olatinwo
authors.forename: C M
authors.initials: CM
authors.lastname: McIntosh
authors.forename: A P
authors.initials: AP
authors.lastname: Alio
authors.forename: H M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D017604:Cesarean Section, Repeat / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D009549:Nigeria / Q000453:epidemiology; D054238:Perinatal Mortality; D006473:Postpartum Hemorrhage / Q000401:mortality*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D012307:Risk Factors