Study on intraoperative blood transfusion and analysis of risk factors in high-risk cesarean pregnancies
Objective To explore the situation of intraoperative blood transfusion in high-risk cesarean delivery,and to analyze its risk factors.Methods A retrospective analysis was conducted on 150 cases of high-risk cesarean delivery admitted to Northwest Women's and Children's Hospital from January 2022 to August 2023,aged 29-43 years,with a gestational age of 31-40 weeks,and they were divided into a transfusion group(63 cases)and a non-transfusion group(87 cases)according to whether they receive blood transfusion during the operation.The clinical data such as age,gestational age,educational background,medical history,distribution of diseases,and coagulation indicators were compared between the two groups,and the risk factors for intraoperative blood transfusion in high-risk cesarean delivery were determined by multivariate logistic regression analysis.t test and x2 test were used.Results In the transfusion group,there were 15 cases(23.81％)with a gestational age ≥37 weeks,32 cases(50.79％)of 34-37 weeks,and 16 cases(25.40％)≤34 weeks,respectively,and those in the non-transfusion group were 68 cases(78.16％),17 cases(19.54％),and 2 cases(2.30％),with a statistically significant difference(x2=46.679,P＜0.001).There were statistically significant differences in the placenta previa rate,placenta implantation rate,hemoglobin(Hb),prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)between the transfusion group and the non-transfusion group[77.78％(49/63)vs.13.79％(12/87),87.30％(55/63)vs.11.49％(10/87),(103.21±8.69)g/L vs.(117.75±10.25)g/L,(11.59±2.35)s vs.(10.22±2.01)s,(29.63±4.14)s vs.(27.22±3.89)s,(18.15±3.02)s vs.(16.81±2.86)s](all P＜0.05).Multivariate logistic regression analysis showed that prolonged gestational age and elevated Hb level were protective factors for intraoperative blood transfusion in high-risk cesarean pregnancy(OR=0.074 and 0.733,both P＜0.05),and placenta previa,placental implantation,and elevated PT level were independent risk factors for intraoperative blood transfusion(OR=102.338,258.237,and 1.964,all P＜0.05).Conclusions In high-risk cesarean pregnancy,prolonged gestation age and elevated Hb level are protective factors for intraoperative blood transfusion,while placenta previa,placenta implantation,and elevated PT level are independent risk factors.Physicians should better assess the need for blood transfusion during high-risk cesarean deliveries and take appropriate preventive measures.
万方数据
维普
