Ariff @ Ghazali, Nazhan Afeef Mohd
(2017)
Blood loss in caesarean section in Hospital Universiti Sains Malaysia (HUSM) : estimation by surgeons and anaesthetists in comparison with quantitative measurement and blood parameters assessments.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: We compared the visual estimation of blood loss for Caesarean section (CS) by
surgeons and anaethetists and their accuracy with relation to years of experience against
quantitative measurement. Haemoglobin (Hb) trend after CS were also studied.
Methods: 134 patients who underwent CS were included. Visual estimations were reported by
surgeons and anaesthetists. The blood volume in collection bottle and disposable items were
quantified. Hb levels pre-CS followed by 1 hour and 24 hours post CS were taken. Data were
tested by Reliability Testing, Independent T-Test, Pearson’s Correlation and Multiple Linear
Regressions where P <0.05 is considered significant.
Results: There were strong correlation between surgeon’s and anaesthetist’s estimations of
blood loss and quantitative measurement with Intraclass Correlation Coefficient of r = 0.828and r = 0.805, P <0.001. Surgeons’ accuracy in estimating blood loss has no significant
difference in less and equal to 5 experience years against more than 6 experience years group,
P= 0.053. Anaesthetists’ accuracy in estimating blood loss has significant difference in less
and equal to 5 experience years against more than 6 experience years group, P= 0.038. There
was moderate negative correlation in between percentage blood loss and Delta Hb 1 hour post
CS, P <0.001. Percentage blood loss, intraoperative fluid administration and patient previous
scars were strong predictors for Delta Hb 1 hour post CS with P < 0.05.
Conclusions: Estimation blood loss for CS by surgeons and anaesthetists in HUSM correlates
with quantitative measurement. Drop in Hb post CS correlates with percentage blood loss.
Prediction of Delta Hb 1 hour and 24 hours post CS can be a useful tool in helping doctors in
managing patient.
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