A feasibility study of measuring maternal anaemia and postoperative outcomes after caesarean section.

Abstract

SummaryIron-deficiency anaemia (IDA) is a global health problem. The impact of IDA on outcomes in obstetric patients who undergo caesarean section (CS) is unknown. We assessed the feasibility of conducting a large study to investigate perioperative anaemia and outcomes after CS. With ethics approval and trial registration, 60 obstetric patients (30 planned CS, 30 emergency CS) were included. Feasibility categories were willingness to participate in a study, to undergo additional blood tests (haemoglobin, ferritin), to have weight measured and to undertake quality of recovery (QoR) questionnaires. Of eligible people approached, 100% agreed to participate and 100% would participate in a future study. Ninety percent (95% confidence interval (CI) 82.4% to 97.6%) and 83% (95% CI 73.9% to 92.7%) agreed to additional tests in hospital and after discharge, respectively. Ninety-eight per cent (95% CI 95.1% to 100%) consented to being weighed, and 100% completed QoR questionnaires. Preoperatively, 8.5% (95% CI 1.4% to 15.6%) of participants were anaemic. Postoperative haemoglobin was measured in only 22 (36.7%, 95% CI 24.5% to 48.9%) participants, and 40.9% (95% CI 20.4% to 61.5%) were anaemic, suggesting at least a quadrupling of the proportion of anaemic patients from pre- to postoperatively. Ferritin was not measured postoperatively in any participant. The prevalence of participants discharged with IDA was unquantifiable. Postoperative IDA in obstetric patients is likely to be a serious problem that is currently unrecognised. Our data suggest that a definitive study to determine associations between maternal anaemia and perioperative outcomes after CS surgery is feasible.