Advantage of Systematic Blood Cell Count 2 Days Post-delivery for the Diagnosis of Postpartum Maternal Anaemia

Abstract

Aims: To evaluate the advantage of full blood cell count as performed 48h post-delivery for the diagnosis of postpartum maternal anaemia. Study Design: Observational retrospective study. Methodology: According to the usual local protocol, haemoglobin assessment is made in all mothers at entry in the labour room (D0), and 2 days post-delivery (D2). The relationship between haemoglobin decrease, anaemia onset, and obstetrical anamnesis has been evaluated by multiple logistic regression analysis. Results: Four hundred and seven (407) parturient women were included. Of them 13.3% (n=54) had >2g haemoglobin loss and were considered having developed undiagnosed postpartum haemorrhage (UDPPH); 10.3% (n=42) had anaemia with <10g/dL haemoglobin at D2. The identified risk factors for postpartum anaemia onset were episiotomy (OR 11.8; 95%CI 4.71-17.5; P <0.001), foetal distress (OR 5.99; 95%CI 2.20-16.3; P <0.001), duration of labour (OR 1.21; 95%CI 1.05-1.40; P<0.008), and presence of perineal and/or vaginal tears (OR 2.9; 95%CI 1.18-7.13; P =0.02). Conclusion: Systematic haemoglobin control in all patients 2 days after vaginal delivery allows the detection and subsequent treatment of UDPPH-related anaemia.