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A retrospective analysis of risk factor of massive bleeding during Caesarean Section
Abstract Number: 57
Abstract Type: Original Research
Obstetric hemorrhage is a main factor of maternal death and the most common contributor to serious obstetric morbidity. Maternal mortality audit data suggest that appropriate preparation and good emergency management leads to improved outcome. The aim of this study was to analysis the risk factor of massive bleeding during Caesarean Section.
All patients who performed caesarean section and managed by anesthesiologists at our university hospital between January 2006 and October 2009 were retrospectively reviewed using the Japanese Society of Anesthesiologists database. Patient characteristics and intraoperative management were retrieved from the Japanese Society of Anesthesiologists database. We divided all patients into two groups, normal bleeding group and massive bleeding group (1500ml≦), and compared background of patients, anesthesia method, operation and anesthesia time, amount of urine, infusion and transfusion between the groups. Multivariate logistic regression analysis was also conducted to elucidate the risk factor of massive bleeding during Caesarean Section.
A total of 676 cases were reviewed, divided 573 patients (85％) into normal bleeding group, 103 patients (15%) into massive bleeding group. There was no significant difference in background of patients (age, height, weight, BMI) and anesthetic methods between the two groups. And there was difference in operation and anesthesia time, amount of infusion and transfusion between the groups. Emergent operation had no association with massive bleeding.
In the multivariate logistic regression analysis, factors having a significant association with hemorrhage were placenta previa (odds ratio 17.9), polycyesis (7.4).
The rate of obstetric hemorrhage during Caesarean Section was 15% 676 deliveries. These findings suggest that placenta previa and polycyesis are a risk factor of obstetric hemorrhage during Caesarean Section. With improvement in planning to deal with serious obstetric morbidity, even better mortality rates may be attainable.