Blood loss after cesarean delivery: a registry-based study in Norway, 1999-2008

OBJECTIVE: The objective of the study was to assess risk factors for moderate and severe blood loss after cesarean delivery (CD). STUDY DESIGN: All planned (n = 32,716) and emergency (n = 47,942) cesareans, as reported over a 10-year period to the Medical Birth Registry of Norway, were analyzed separately in a case-control design. Women with moderate (500 to <= 1500 mL) or severe (>1500 mL) blood loss were analyzed with women with blood loss less than 500 mL as controls in SPSS (version 17.0) with chi(2) test and logistic regression. RESULTS: The prevalence of severe blood loss was consistently higher in emergency (3.2%) than planned CD (1.9%). Planned and emergency CDs share common risk factors for both moderate and severe blood loss, whereas emergency CD carries in addition delivery-related risk factors. CONCLUSION: When revising management schemes for CD, anesthetic procedures should be reconsidered as surgical competence in cases with placenta previa, placental abruption, and low hemoglobin.