000			04379nam a22006137a 4500
008			210607s20212021 xxu||||| |||| 00| 0 eng d
022			_a2589-9333
024			_a10.1016/j.ajogmf.2021.100368 [doi]
024			_aS2589-9333(21)00063-X [pii]
040			_aOvid MEDLINE(R)
099			_a33831587
245			_aEffect of mild preoperative thrombocytopenia on postpartum hemorrhage after cesarean deliveries.
247			_aCondensation: Mild gestational thrombocytopenia does not confer increased risk for postpartum hemorrhage or red blood transfusion for women undergoing cesarean delivery.
251			_aAmerican Journal of Obstetrics & Gynecology MFM. 3(4):100368, 2021 07.
252			_aAm J Obstet Gynecol MFM. 3(4):100368, 2021 07.
252			_zAm J Obstet Gynecol MFM. :100368, 2021 Apr 05
253			_aAmerican journal of obstetrics & gynecology MFM
260			_c2021
260			_fFY2022
265			_saheadofprint
265			_sppublish
266			_d2021-06-07
268			_aAmerican Journal of Obstetrics & Gynecology MFM. :100368, 2021 Apr 05
269			_fFY2021
520			_aBACKGROUND: Thrombocytopenia at time of delivery is considered to be a risk factor for postpartum hemorrhage. However, platelet count thresholds for postpartum hemorrhage are variable and not extensively studied.
520			_aCONCLUSION: Preoperative mild thrombocytopenia was not associated with postpartum hemorrhage, red blood cell transfusion, wound complications, or postpartum Emergency Department visits in women undergoing cesarean delivery. Copyright (c) 2021. Published by Elsevier Inc.
520			_aOBJECTIVE: To examine if mild thrombocytopenia is associated with an increased risk of postpartum hemorrhage among women undergoing cesarean delivery.
520			_aRESULTS: Of 3,133 women, 2,799 (89.3%) had normal platelet levels, 298 (9.5%) had mild thrombocytopenia, and 36 (1.2%) had moderate to severe thrombocytopenia. There were no differences in the risks of postpartum hemorrhage, need for a red blood cell transfusion, wound complications or postpartum Emergency Department visit comparing women with normal platelet counts to those with mild thrombocytopenia (24.6% vs. 25.8% [aOR 1.16; 95%CI 0.88-1.54]; 6.5% vs 6.7% [aOR 1.34; 95%CI 0.80-2.24]; 4.5% vs. 5.4% [aOR 1.53; 95%CI 0.88-2.64]; 9.0% vs. 10.7% [aOR 1.37; 95%CI 0.92-2.03, respectively).
520			_aSTUDY DESIGN: This was a retrospective cohort study of all women who underwent a cesarean delivery at a tertiary care hospital Labor and Delivery unit from September 2015 to June 2018. Women with normal platelet counts (>=150,000/microL) were compared to women with mild thrombocytopenia (100-149,000/microL). Women were excluded if they had moderate to severe thrombocytopenia (platelet count less than 100,000/microL) or had received a platelet transfusion. The primary outcome was postpartum hemorrhage (quantitative blood loss >=1000 mL). Secondary outcomes included frequencies of red blood cell transfusion, wound complications (surgical site infections, dehiscence, or hematoma), and postpartum Emergency Department visits. Adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) were calculated, controlling for maternal age, gestational age, BMI, scheduled cesarean, hypertension, and pre-operative hemoglobin level.
546			_aEnglish
650			_a*Postpartum Hemorrhage
650			_a*Thrombocytopenia
650			_aCesarean Section/ae [Adverse Effects]
650			_aFemale
650			_aGestational Age
650			_aHumans
650			_aPostpartum Hemorrhage/ep [Epidemiology]
650			_aPregnancy
650			_aRetrospective Studies
650			_aThrombocytopenia/ep [Epidemiology]
651			_aMedStar Washington Hospital Center
651			_aMedStar Washington Hospital Centeretsuya
656			_aMaternal-Fetal Medicine Fellowship
656			_aObstetrics & Gynecology Residency
656			_aObstetrics and Gynecology/Maternal-Fetal Medicine
657			_aJournal Article
700			_aDiSciullo, Alison
700			_aKawakita, Tetsuya
700			_aLandy, Helain
700			_aMokhtari, Neggin
790			_aDiSciullo A, Kawakita T, Landy H, Mokhtari N
856			_uhttps://dx.doi.org/10.1016/j.ajogmf.2021.100368 _zhttps://dx.doi.org/10.1016/j.ajogmf.2021.100368
942			_cART _dArticle
999			_c6327 _d6327