Advantage of Systematic Blood Cell Count 2 Days Post-delivery for the Diagnosis of Postpartum Maternal Anaemia
N. Charafeddine
Service de Gynécologie Obstétrique, Hôpital Foch, Suresnes, France.
O. Picone
Service de Gynécologie Obstétrique, Hôpital Foch, Suresnes, France.
E. Bony
Service de Gynécologie Obstétrique, Hôpital Foch, Suresnes, France.
J. F. Dreyfuss
DRCI, Hôpital Foch, Suresnes, France.
F. Zraik-Ayoubi
Unilabs France, Paris, France.
J. M. Ayoubi *
Service de Gynécologie Obstétrique, Hôpital Foch, Suresnes, France and Université Versailles St Quentin en Yvelines, UFR Paris Ile de France Ouest, France.
*Author to whom correspondence should be addressed.
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.
Keywords: Undiagnosed postpartum haemorrhage, post partum, anaemia.