Help, what is lowest Hematocrit for post C-section

KSEFLINK · Mar 16, 2001

With a crit that low she should be transfused. Some OB's prefer to do the wait and see routine, but I can tell you she will not feel very well for a long time. A nurse friend of mine had a crit of 7.5 on return home after bleeding and ended up having to come back to get blood outpatient and not enjoying her baby (literally cuz she did not have an ounce of energy). Have her get a second opinion! There are always the inherent risks of transfusion reaction and a little greater risk of problems post delivery. Be an advocate for her

hollykate · Mar 16, 2001

ok, I am no OB rn, but maybe the hospital is thinking that the low crit is dilutional? And as she diuresis (SP??) the crit will rise. but I do agree a transfusion may be in order. I work a surgery trauma ICU and we often do not transfuse until crit is way way low- 7-8 but thats just the way we do it here and I am not even saying the way we do it is right, I'm open for info.

bbnurse · Mar 17, 2001

OBs are bound by some ACOG standards and the Bloodbank criteria to transfuse at 7 IF symptomatic. If not dizzy or hypotensive, Fe is prescribed. Theory is that most pregnant people are young, healthy and if not feeling symptomatic, can recover on their own.

tangrene · Mar 17, 2001

Thanks everyone!! I feel better knowing that they are not being letting her get too low. She has been unable to get out of bed and walk, but she was able to sit up in a bedside chair for a short while but was too weak to hold the babies for more than a min. They are going to send her home with my mom who is also a nurse who went there to help. So the plan is to just deliver babies to her in bed while mom and dad change and bath babies till she is able to be less symptomatic.

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MartyL · Mar 20, 2001

How low is too low a 'crit? How does it affect the patient. I had a C-section with my last child. My hgb droped to 6 and 'crit was 20! If my doctor "rushed" to give me a transfusion when all I was feeling is tiredness and mild exertional shortness of breath, I would have ran the risk of a blood-related disease such as Hepatitis!! There are alternatives to blood transfusions and as nurses we should educate ourselves about these safer, better alternatives. Check into the "Bloodless Medicine and Surgery" programs that are in place at many progressive institutions. There are many things that the body can cope with and adapt to without resorting to treating the patient with the most "comfortable" treatment for us. For every treatment there are options, alternatives, and hazards. Currently when it comes to blood products, the Jehovah's Witnesses are best educated patient population. (They know more than we nurses do about blood alternatives and treatment of anemias!) We should all learn a little about alternatives to blood and NOT just for the sake of JW patients but for ALL of our patients. I am glad that I did not have to run the risk of a transfusion.