ASA: Studies Present Solutions for Preventing Blood Loss After Cesarean

MONDAY, Oct. 30, 2023 (HealthDay News) — Calcium chloride (CaCl) can reduce quantitative blood loss (QBL) after cesarean delivery and a uterine tone score can predict outcomes after cesarean delivery, according to two studies presented at ANESTHESIOLOGY 2023, the annual meeting of the American Society of Anesthesiologists, held from Oct. 13 to 17 in San Francisco.

Alla Yarmosh, M.D., from Stanford University in Palo Alto, California, and colleagues conducted a single-center, double-blind, randomized trial involving laboring patients who received an oxytocin infusion and subsequently required cesarean delivery. Patients were randomly assigned to receive 1 g intravenous CaCl in 60-mL total volume or 60 mL saline placebo control infusion (60 patients in each group). The researchers found that CaCl significantly reduced QBL in the adjusted analysis and in the subgroup analysis excluding patients with nonatonic surgical bleeding. Recipients of CaCl tolerated the drug infusion well.

In a second study, James Xie, M.D., from Stanford University in California, and colleagues implemented a uterine tone scoring system for all cesarean deliveries in 2022. The feasibility of recording scores was examined, as was the association between the score and hemorrhage outcomes. Anesthesiologists were prompted to record uterine tone scores two, seven, and 12 minutes after fetal delivery. The researchers found that the 12-minute uterine tone score predicted postpartum hemorrhage, major hemorrhage, and transfusion with areas under the receiver operating characteristic curve of 0.76, 0.81, and 0.76, respectively. The predicted QBL was 559; 1,200; 1,750; and 2,600 mL with tone scores of 10, 6, 4, and 2, respectively.

“If our findings can be confirmed in larger studies, it could transform the way we prevent and treat postpartum hemorrhage,” Jessica Ansari, M.D., also from Stanford University and coauthor of both studies, said in a statement.

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