Blood transfusion and caesarean section.

A clinical audit of 1,000 consecutive Caesarean sections at the Royal Women's Hospital indicated that 9.4% of patients required blood transfusion. Urgent blood transfusion was required in 53% of the 33 patients requiring Caesarean section because of placenta praevia, 43% of the 23 with accidental haemorrhage, 11% of the 36 with severe preeclampsia, but in only 2.3% of the remaining 908 patients. Blood was cross-matched preoperatively in 47.7% of patients and 90% of this blood was either not administered or given as a delayed nonurgent procedure. It is suggested that routine preoperative cross-matching of blood could be replaced by a blood type and antibody screening procedure for Caesarean sections being performed for those indications associated with low risk of blood transfusion requirement.