Perioperative Anemia in Patients Planned for Cesarean Deliveries: A Quality Improvement Audit from a Private Tertiary Care Center of Pakistan

Objective: Anemia in women undergoing cesarean delivery (CD) is serious concern due to consequences related to maternal and fetal health. The objective of this audit was to determine prevalence of anemia in patients planned for CD. Methodology: The retrospective record of patients from 2021 to 2023 was reviewed for age, comorbid conditions, number of pack cell transfusions done, admitting hemoglobin (Hb), discharge Hb and length of Stay (LOS) in hospital. Results: In total, data of 4,578 patients was reviewed. Nearly half (54.3%) of them were proceeded as elective case. The association of comorbid conditions was there in 55% of parturients. Amongst them gestational diabetes (55%) and hypertensive disorders (16%) were the commonest one. Overall, 44 % of patients were anemic at admission and 13 % had anemia at discharge. Only, 3.4 % of women required any sought of blood transfusion. Conclusion: The prevalence of anemia in patients undergoing CD at our center was found to be very high. Evidence based guideline for its management in antenatal period has been developed and implemented. Patient education brochure is also formulated to improve the efficacy of oral iron therapy and its being used as a part of antenatal counselling. The re-audit cycle will be planned to see the impact of implemented guidelines in reducing the prevalence of anemia in our patients planned for CDs.