Abstract

Objective: To identify determinants of hemorrhage during cesarean section (HCS). Material and methods: This case-control study was carried out between 1 st February and 31 st May 2026. Women with or without HCS were recruited. The main variables recorded included maternal age and parity, cesarean section (CS) indication, hemoglobin concentration, platelet count and prothrombin time prior to CS, and birth weight. Fisher exact test, t-test and logistic regression were used for comparison. P<0.05 was considered statistically significant. Results: Of 458 CSs, 105 had HCS (22.9%). Two women with HCS were excluded. Amongst the 309 women of the population under study (103 with HCS and 206 without HCS), emergency CS was carried out in 253 of them (81.9%). Significant independent factors associated with HCS were placenta abruption (aOR 96.42, 95%CI 1.75-502.70), placenta praevia (aOR 19.95, 95%CI 3.28-121.60), parity ≥4 (aOR 3.19, 95%CI 1.52-6.71) and prothrombin time <70% (aOR 8.33, 95%CI 0.96-86.2). Conclusion: Women with placenta abruption, placenta praevia, prothrombin time <70% and women of parity ≥4 should be informed they are at risk of HCS. Therefore, their CSs should be performed in well-equipped settings and they should have enough blood cross matched before CS.

Keywords

cesarean section, hemorrhage, multiparity, placenta abruption, placenta praevia