The rate of bleeding during cesarean section in pregnant women with COVID-19 admitted to hospitals in Tabriz, 2021

Document Type : Original Article


1 Assistant Professor, Department of Obstetrics and Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2 Obstetrics and Gynecologist, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Medical Student, Student Research Committee, Qom University of Medical Sciences, Qom, Iran.

4 PhD in Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.

5 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

6 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.


Introduction: Intensification of immune system sensitivity after pregnancy with cytokine storm caused by Covid 19 can lead to coagulation disorders and increase the amount of bleeding after delivery. Since bleeding following cesarean section is more likely to occur in women with Covid-19 than in women without the disease, the present study was performed aimed to investigate the amount of bleeding during caesarean section in women with covid-19.
Methods: This descriptive-analytical study was performed on 396 clinical files of women after cesarean section (35 women with Covid 19 and 361 women without Covid 19) in Al-Zahra and Imam Reza hospitals of Tabriz. Demographic information, history of midwifery and bleeding volume, platelets, prothrombin time, and relative thromboblastin time were extracted for each individual. Data were analyzed by SPSS statistical software (version 21) and student's t-test, chi-square and multivariate regression. P< 0.05 was considered statistically significant.
Results: The rate of bleeding in patients with Covid 19 (1259.59 ± 127.69 ml) was significantly higher than patients without Covid 19 (351.74 ± 11.94 ml) (p=0.005). The rate of bleeding during cesarean section for patients with Covid 19 based on the severity of the disease indicated that the higher the severity of the disease, the higher the bleeding during cesarean section (P=0.001). Finally, it was found that severe Covid 19 increases the bleeding of cesarean section by 12.95 times (95% CI: 8.35-15.95).
Conclusion: Infection to high intensity Covid 19 can increase the risk of bleeding during cesarean section; therefore, measures and planning such as blood preparation and access to appropriate veins for blood transfusion management should be considered.


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