Abstract
Objective To evaluate fetomaternal bleeding following routine cesarean delivery compared with
cesarean delivery involving transplacental transection.
Study Design A prospective cohort study evaluating cesarean delivery in which the placenta was
transected (cases) versus controls (placenta not transected) from January 2016 to
April 2018. A maternal Kleihauer–Betke's (KB) test and newborn hematocrit were performed
shortly after delivery.
Results The rate of a positive KB test was not significantly different between cases (n = 31) and controls (n = 61) (19 vs. 14%; odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.46–4.49;
p = 0.74). Median neonatal hematocrits were not different. However, the rate of newborn
hematocrits <40% at delivery was higher in cases compared with controls (23 vs. 3%;
OR: 8.90; 95% CI: 1.72–45.90; p = 0.005).
Conclusion A cesarean requiring transplacental transection to accomplish delivery does not significantly
increase the rate of fetomaternal bleeding but is associated with a higher likelihood
of newborn hematocrit <40% at delivery.
Keywords
Kleihauer–Betke - fetomaternal bleeding - cesarean delivery - fetomaternal hemorrhage
- neonatal hematocrit
