Investigation of the causes of blood transfusion during natural delivery and cesarean section in pregnant women referred to Imam Sajjad Maternity Hospital in Yasuj in 1401 and 1402: A descriptive analytical study

Introduction and Objective: One of the main causes of maternal mortality worldwide is severe bleeding, which is caused by various complications such as uterine atony, placenta previa, and difficult labor. This study investigated the causes of blood transfusion in normal and cesarean deliveries in pregnant women referred to Imam Sajjad Hospital in Yasouj during 1401 and 1402.

Methods: This descriptive-analytical study, and pregnant women hospitalized for labor who were at least 24 weeks pregnant and received blood or blood products, were examined as a whole census. Data collection was performed using a checklist including demographic information, underlying causes and risk factors for bleeding, and details of blood transfusion. Descriptive analysis was performed using SPSS version 21 software, including describing quantitative variables of mean and standard deviation, to describe qualitative variables of percentage and frequency, and to compare two groups, chi-square was used.
Results: A total of 126 blood transfusions were recorded, 47.6% of which were related to vaginal delivery and 52.4% to cesarean section. Mothers with an age range (18-35 years) and higher BMI (≥30) had the highest blood transfusion and were also more common in cesarean section. High blood pressure (both systolic and diastolic) (21.2%) and diabetes (18.2%) were also more common in cesarean sections. Most blood transfusions were in women with less than three previous deliveries (84.1%) and the most common postpartum complications were uterine atony (61.6%) and placental abnormalities such as retained placenta (22.2%). Placental abnormalities (separation, placenta previa, and placenta accreta) emerged as important factors in the need for blood transfusion in cesarean sections. In contrast, uterine atony, ruptured birth canal, and retained placenta were prominent in cases of vaginal delivery (NVD).
Conclusion: This study emphasizes the importance of identifying risk factors such as maternal age, body mass index, and comorbidities. The findings can help health policy makers to improve the quality of obstetric care based on local risk profiles. It also allows for better consultation with mothers when determining the method of delivery and timely and effective preparation for prevention and treatment in high-risk cases.
Blood transfusion, cesarean delivery, vaginal delivery, risk factors

Results: A total of 126 blood transfusions were recorded, 47.6% of which were related to vaginal delivery and 52.4% to cesarean section. Mothers with an age range (18-35 years) and higher BMI (≥30) had the highest blood transfusion and were also more common in cesarean section. High blood pressure (both systolic and diastolic) (21.2%) and diabetes (18.2%) were also more common in cesarean sections. Most blood transfusions were in women with less than three previous deliveries (84.1%) and the most common postpartum complications were uterine atony (61.6%) and placental abnormalities such as retained placenta (22.2%). Placental abnormalities (separation, placenta previa, and placenta accreta) emerged as important factors in the need for blood transfusion in cesarean sections. In contrast, uterine atony, ruptured birth canal, and retained placenta were prominent in cases of vaginal delivery (NVD). Conclusion: This study emphasizes the importance of identifying risk factors such as maternal age, body mass index, and comorbidities. The findings can help health policy makers to improve the quality of obstetric care based on local risk profiles.