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Objective. To analyze risk factors for peroperative excessive blood loss at cesarean delivery. Design. Case-control study. Setting. Twenty-four of 26 maternity units in Norway with at least 500 expected deliveries per year. Sample. A total of 2,778 women having singleton deliveries and participating in the Norwegian Breakthrough Project on Cesarean Section. Methods. Elective and emergency operations were analyzed separately with extensive blood loss defined as hemorrhage > 1000 ml with controls defined as bleeding < 500 ml. All analyzes were done in SPSS (version 16.0) with chi-squared tests and logistic regression. Main outcome measures. Adjusted odds ratios (aOR) of extensive peroperative bleeding. Results. The prevalence of excessive blood loss differed between women undergoing elective (2.1%) and emergency cesarean deliveries (3.3%). Among maternal factors, chronic maternal diseases, pregnancy and delivery related conditions, placenta previa (aOR 19.7; 95% CI 5.4–72.2) and transverse lie (aOR 4.9; 95% CI 0.9–26.5) were the only risk factors for extensive blood loss in elective operations, whereas placenta previa (aOR 8.4; 95% CI 2.4–29.9), placental abruption (aOR 2.0; 95% CI 2.0–14.5), intervention at full cervical dilation (aOR 3.2; 95% CI 1.4–7.1) and high BMI (aOR 3.4; 95% CI 1.6–7.2) were risks in emergency operations. Conclusion. The different risk pattern for excessive bleeding in cesarean deliveries should be recognized when planning available obstetric competence for surgery. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to assess risk factors for moderate and severe blood loss after cesarean delivery (CD). Study Design: All planned (n = 32,716) and emergency (n = 47,942) cesareans, as reported over a 10-year period to the Medical Birth Registry of Norway, were analyzed separately in a case-control design. Women with moderate (500 to ≤1500 mL) or severe (>1500 mL) blood loss were analyzed with women with blood loss less than 500 mL as controls in SPSS (version 17.0) with χ2 test and logistic regression. Results: The prevalence of severe blood loss was consistently higher in emergency (3.2%) than planned CD (1.9%). Planned and emergency CDs share common risk factors for both moderate and severe blood loss, whereas emergency CD carries in addition delivery-related risk factors. Conclusion: When revising management schemes for CD, anesthetic procedures should be reconsidered as surgical competence in cases with placenta previa, placental abruption, and low hemoglobin. [ABSTRACT FROM AUTHOR]