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Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection

Objective  To evaluate fetomaternal bleeding following routine cesarean delivery compared with cesarean delivery involving transplacental transection. Study Design  A prospective cohort study evaluating cesarean delivery in which the placenta was transected (cases) versus controls (placenta not tran...

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Detalles Bibliográficos
Autores principales: Gregory, Emily, Towers, Craig V., van Nes, Jaclyn, Shumard, Kristina, Fortner, Kim B., Weitz, Beth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753006/
https://www.ncbi.nlm.nih.gov/pubmed/31544010
http://dx.doi.org/10.1055/s-0039-1697654
Descripción
Sumario:Objective  To evaluate fetomaternal bleeding following routine cesarean delivery compared with cesarean delivery involving transplacental transection. Study Design  A prospective cohort study evaluating cesarean delivery in which the placenta was transected (cases) versus controls (placenta not transected) from January 2016 to April 2018. A maternal Kleihauer–Betke's (KB) test and newborn hematocrit were performed shortly after delivery. Results  The rate of a positive KB test was not significantly different between cases ( n  = 31) and controls ( n  = 61) (19 vs. 14%; odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.46–4.49; p  = 0.74). Median neonatal hematocrits were not different. However, the rate of newborn hematocrits <40% at delivery was higher in cases compared with controls (23 vs. 3%; OR: 8.90; 95% CI: 1.72–45.90; p  = 0.005). Conclusion  A cesarean requiring transplacental transection to accomplish delivery does not significantly increase the rate of fetomaternal bleeding but is associated with a higher likelihood of newborn hematocrit <40% at delivery.