Defining peri-operative anaemia in pregnant women – challenging the status quo

Abstract

Peri-operative anaemia is a significant risk factor for morbidity and mortality. Anaemia during pregnancy is associated with adverse maternal and neonatal outcomes, and postpartum haemorrhage remains a leading cause of maternal mortality worldwide. Caesarean section is an operation incurring moderate risk of bleeding, and rates are rising globally. Recent international consensus guidelines recommend targeting a pre-operative haemoglobin > 130 g.l−1 for all patients having surgery with moderate-to-high risk of bleeding, regardless of sex. It is unclear how this recommendation translates to pregnant women, where anaemia is defined at a much lower haemoglobin level of < 110 g.l−1. Long-standing..