Blood Loss at Caesarean Section: A Five-Year Single Centre Experience in the Niger Delta

Abstract

Objective: The objective of this study is to review outcomes of our caesarean delivery in terms of: - amount of intraoperative blood loss and whether this compares favourably with blood loss at other centres. - to compare the effects various calibers of surgeons and experience impact on blood loss at caesarean section. - the effects  unbooked emergencies impact on blood loss at caesarean section. - the impact of the time spent by the surgeon on the degree of blood loss. - the effect of fetal macrosomia, gestational age at caesarean delivery, previous caesarean section has on blood loss at caesarean section. - to identify areas where improvements can be made. Methodology: This was a descriptive, cross-sectional, retrospective study. This study was carried out at the Department of Obstetrics and Gynaecology,  Niger  Delta University Teaching Hospital, Okolobiri, Bayelsa state Nigeria. Eight hundred and forty eight subjects who delivered between January 2008 and January 2013 (both those who registered for antenatal care and those who were referred as emergencies) were recruited into the study. The records of the subjects for the study were extracted from their hospital files and the results so obtained coded into SPSS version 20 for analysis.  Results: The Mean blood loss at caesarean section for the study was 712.3 ml ± 389.5. There was no statistically significance difference  between group means of blood loss by Consultants, Seniour Residents and Juniour Residents at Caesarean section as determined by one-way ANOVA (F.803= 1.252, P= .721 and .207 ). The mean time duration of surgery for the study was 63.57 ± 18.74 minutes. There was no statistically significant difference between  the means of the time spent by Consultants, Seniour Residents and Juniour Residents as determined by the Oneway ANOVA test (F 1.021= -801, P= .444, .787). Conclusion: Unbooked emergencies contributed so much to the degree of blood loss amongst other variable factors in this study.  This is an issue that has plagued obstetric practice in sub-Saharan Africa and a major contributor to maternal morbidity and mortality. Caregivers and stake holders alike including governments, non-governmental organizations need to invest money and time including advocacy to reduce this ugly trend.