Objective: The aim of our study was to evaluate the factors affecting postoperative hemoglobin (Hb) decrease in primary cesarean section patients.

Methods: A total of 560 patients who underwent primary caesarean section between January 2016 and December 2016 were evaluated retrospectively. These patients were divided into two groups according to postoperative Hb values: patients with Hb decrease ≥2 g/dL or <2 g/dL. There were 142 patients with Hb decrease ≥2 g/dL. Preoperative and postoperative 24th hour Hb and hematocrit levels, and factors leading to Hb decrease were evaluated.

Results: Of the 560 pregnant women included in the study, 289 (51.60%) had emergent caesarean sections, while 271 (48.39%) were elective cesarean sections. Demographic data, distribution of cesarean indications and obstetric characteristics were not different between the two groups. Postoperative erythrocyte transfusion requirement was significantly different between the groups (p<0.001). The development of atony and additional uterotonic requirement were significantly higher in the group with Hb decrease ≥2 g/dL.

Conclusion: Postoperative Hb decrease is relatively rare in primary cesarean sections. Although severe blood loss and blood product transfusion are rare, caution should be exercised if there is a risk factor in primary cesarean sections.