Which obstetric condition most frequently requires blood transfusions during or after cesarean delivery?

Which obstetric condition most frequently requires blood transfusions during or after cesarean delivery?

• A. Multiple gestations
• B. Preeclampsia
• C. Intrauterine fetal demise
• D. Placenta previa

Answer: (D)

Heavy hemorrhage during cesarean is most likely when the placenta sits over or near the cervical os. Placenta previa places the placental attachment in the lower uterus, making surgical delivery more prone to brisk bleeding from the placental bed as the uterus is incised and the placenta may separate poorly. The risk is further increased if placenta accreta spectrum is present, which makes bleeding harder to control and often necessitates transfusion. Other scenarios, like multiple gestations or preeclampsia, can raise overall risk of blood loss, but the pattern of heavy, difficult-to-control bleeding that leads to transfusion is most tightly linked to placenta previa. Hence this condition is most frequently associated with transfusion during or after cesarean.

Heavy hemorrhage during cesarean is most likely when the placenta sits over or near the cervical os. Placenta previa places the placental attachment in the lower uterus, making surgical delivery more prone to brisk bleeding from the placental bed as the uterus is incised and the placenta may separate poorly. The risk is further increased if placenta accreta spectrum is present, which makes bleeding harder to control and often necessitates transfusion. Other scenarios, like multiple gestations or preeclampsia, can raise overall risk of blood loss, but the pattern of heavy, difficult-to-control bleeding that leads to transfusion is most tightly linked to placenta previa. Hence this condition is most frequently associated with transfusion during or after cesarean.