Risk factors for autologous blood withdrawal-reinfusion in cesarean section / 中华麻醉学杂志

ABSTRACT

Objective To determine the risk factors for autologous blood withdrawal-reinfusion in cesarean section. Methods Parturients who underwent cesarean section and autologous blood withdrawal from August 2012 to June 2015 in our hospital were selected. The preoperative, intraoperative and postop-erative data of the parturients were collected retrospectively from electronic medical records. The parturients were divided into reinfusion group and non-reinfusion group according to whether the parturients received au-tologous blood reinfusion. Logistic regression analysis was used to stratify the risk factors for autologous blood withdrawal-reinfusion in cesarean section. Results A total of 1604 parturients who received autolo-gous blood reinfusion were included in the study, with 757 cases in reinfusion group and 847 cases in non-reinfusion group. Placenta increta∕percreta, placenta previa with previous uterine surgery and complete pla-centa previa were the risk factors for autologous blood withdrawal-reinfusion in cesarean section (P<0. 05). The predictive model was exp( w) ÷ [1 + exp( w)],w = 1. 447 × placenta increta∕percreta ( corrected OR value)+0. 945×complete placenta previa (corrected OR value)+1. 361×placenta previa with previous uter-ine surgery (corrected OR value). The sensitivity and specificity of this model in predicting blood reinfusion were 56％ and 79％, respectively, the positive predictive value was 71％, and the negative predictive val-ue was 67％. Conclusion Placenta increta∕percreta, placenta previa with previous uterine surgery and complete placenta previa are high risk factors for autologous blood withdrawal-reinfusion in cesarean section, and routine preparation for autologous blood withdrawal-reinfusion is recommended.