Preoperative blood transfusion, is it essential to arrange blood for patients undergoing caesarean section?

Objective: To assess the need of blood for the patients undergoing caesarean section

Place and Duration of Study: This retrospective study was conducted in Combined Military Hospital [CMH]Jhelum from December 2011 to November 2012

Material and Methods: A total of 224 Caesarean sections done at CMH Jhelum from Dec 2011 to Nov 2012 having American Society of Anaesthesiology [ASA] I and ASA II were included in the study. Patients, who met the preset inclusion criteria i.e. age 20 to 40 years, ASA I / ASA II, primigraveda, previous one, two or three C- sections emergency/ electives were included in the study. Patients with deranged coagulation profile, bleeding disorders, active bleeding [placenta praevia, abruptio placentae] and patients on anticoagulants were excluded from the study. One unit of blood was arranged for patient having hemoglobin [Hb] > 10gm/dl and two units for patient having Hb less than 10gm/dl. Blood was transfused when loss was above 20%, and intravenous fluids given when loss was less than 20%

Results: Out of 224, 181 patients underwent elective C-section and 43 emergency C sections. Emergency surgery was carried out in case of failed induction, cord prolapse, previous C-section in labour and fetal distress. Total 21 patients were considered to receive blood transfusion of which 5 had Hb > 10gm/dl, 5 had Hb between 8-10 gm/dl and 11 patients had HB < 8 gm/dl. Two patients among 11who had Hb less than 8 gm/dl were not given transfusion due to non- availability of blood rest nine received blood. So in fact 19 patients were given blood transfusion

Postobstructive pulmonary edema associated with biting a laryngeal mask airway

Laryngeal mask airway [LMA] has established itself as a reliable mode of maintaining a patent airway; however, it is associated with a few complications. This case report describes the presentation, diagnosis, management and treatment of an unusual complication associated with the use of LMA, that is postobstructive pulmonary edema [POPE], which is a potentially life-threatening complication of acute airway obstruction. It develops rapidly but responds quickly to the therapy