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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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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
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author Gregory, Emily
Towers, Craig V.
van Nes, Jaclyn
Shumard, Kristina
Fortner, Kim B.
Weitz, Beth
author_facet Gregory, Emily
Towers, Craig V.
van Nes, Jaclyn
Shumard, Kristina
Fortner, Kim B.
Weitz, Beth
author_sort Gregory, Emily
collection PubMed
description 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.
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spelling pubmed-67530062019-09-20 Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection Gregory, Emily Towers, Craig V. van Nes, Jaclyn Shumard, Kristina Fortner, Kim B. Weitz, Beth AJP Rep 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. Thieme Medical Publishers 2019-07 2019-09-19 /pmc/articles/PMC6753006/ /pubmed/31544010 http://dx.doi.org/10.1055/s-0039-1697654 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Gregory, Emily
Towers, Craig V.
van Nes, Jaclyn
Shumard, Kristina
Fortner, Kim B.
Weitz, Beth
Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title_full Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title_fullStr Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title_full_unstemmed Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title_short Fetomaternal Bleeding and Neonatal Hematocrit following Cesarean Delivery: Routine versus Transplacental Transection
title_sort fetomaternal bleeding and neonatal hematocrit following cesarean delivery: routine versus transplacental transection
url 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
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