Optimal timing of post-operative haematocrit check in obstetric and gynaecological surgeries
Keywords:
postoperative, haematocrit, obstetrics, gynaecologyAbstract
Background: Haemorrhage is a feared albeit common complication of surgery in Obstetrics and Gynaecology. Measurement of haematocrit post operatively is believed to be part of good medical practice since it gives an inkling to intraoperative and immediate post-operative blood loss and the need for blood transfusion. The objective of the study is to determine if there was any difference between haematocrit values gotten on day 1 and 2 and also to determine the optimal time for the post-operative haematocrit check.
Methods: One thousand patients who had surgery in the department of Obstetrics and Gynaecology of LAUTECH Teaching Hospital (LTH) and Bowen University Teaching Hospital (BUTH), Ogbomoso were recruited. Capillary blood samples were obtained at 24hours and 48 hours post operatively. The haematocrit was determined using a 24 place micro haematocrit centrifuge and the values checked using a haematocrit reader. Frequency tables and charts were made and results were tested for significance with level of significance (x) set at 0.05.
Results: The mean age of the patients was 32.88±9.45, with a modal age group of 21-30years. The commonest obstetric surgery done was caesarean section (60.6%) while the commonest gynaecological surgery was myomectomy (13.8%). There is a significant difference between the haematocrit values gotten on day one and two (p= 0.000). There was significant difference between the haematocrit values on both days and the unit the patient was managed; the type of surgery done and the age group of the patient.
Conclusion: The haematocrit on postoperative day 2 is more representative of the blood loss.
References
Tomacruz RS, Bristow RE, Montz FJ.
Management of pelvic hemorrhage. Surg Clin North Am. 2001;8(14):925–948
Tinelli A. Post-Cesarean Section Hemorrage
Treated by a Collagen Patch Coated with the Human Coagulation Factors. J Clinic Case Reports. 2011. 1:e103. doi:10.4172/2165-
1000e103 (accessed 5th February 2018)
Erian M, Mc Laren G, Khalil A. Reactionary Hemorrhage in Gynecological Surgery. JSLS. 2008;12(1): 81–84
Nagra NS, Popta D, Whiteside S, Holt EM. An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur. Acta
O r t h o p a e d i c a e t Tr a u m a t o l o g i c a
Turcica.2016;50:(5): 507-513
Halm EA, Wang JJ, Boockvar K, Penrod J, Silberzweig SB, Magaziner J. Effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture. J Orthop Trauma.2004;18(6):369-374
Khalfaoui MY, Godavitarne C, Wilkinson MCP. Optimal Timing for Hemoglobin Concentration Determination after Total Knee Arthroplasty: Day
versus Day 2. Knee Surg Relat Res.
;29(1):52-56.
Barsuk JH, Szmuilowicz E. Evaluating medical procedures: Evaluation and transfer to bedside . In: Pangaro LN, McGaghie WC (eds). Alliance for Education's Handbook on Medical Student Evaluation and Assessment. 1st ed. Syracuse, New York: Gegensartz press; 2015. p114
Kelly MP, Heath I, Howick J, Greenhalgh T. The importance of values in evidence-based medicine. BMC Med Ethics. 2015; 16: 69.
Marietta M, Facchini L, Pedrazzi P, Busani S, Torelli G. Pathophysiology of bleeding in surgery. Transplant Proc. 2006; 38(3):812-4.
Gao F-Q, Li Z-J, Zhang K, Sun W, Zhang H. Four Methods for Calculating Blood-loss after Total Knee Arthroplasty. Chinese Medical Journal. 2015;128(21):2856-2860
Audu LI, Otuneye AT, Mairami AB, Mshelia LJ, Nwatah VE. Posttransfusion Haematocrit Equilibration: Timing Posttransfusion Haematocrit Check in Neonates at the National Hospital, Abuja, Nigeria. International Journal of Pediatrics. 2015;2015: 1-5
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Research Journal of Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Research Journal of Health Sciences journal is a peer reviewed, Open Access journal. The Journal subscribed to terms and conditions of Open Access publication. Articles are distributed under the terms of Creative Commons License (CC BY-NC-ND 4.0). (http://creativecommons.org/licences/by-nc-nd/4.0). All articles are made freely accessible for everyone to read, download, copy and distribute as long as appropriate credit is given and the new creations are licensed under the identical terms.
