What is the role of a CBC count prior to a cesarean delivery (C-section)?

Updated: Dec 14, 2018
  • Author: Hedwige Saint Louis, MD, MPH, FACOG; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

When patients are admitted for labor and delivery, most have blood drawn for a complete blood count (CBC) and type and screen when an intravenous (IV) line is started, which is a basic requirement for patients when they are admitted to the labor floor. In addition, tests for HIV antibodies and hepatitis B surface antigen and a screening test for syphilis are done, if these have not been recently obtained.

If the patient has a hemoglobin level within the reference range, has had an uncomplicated pregnancy, and is anticipated to have a vaginal delivery, the utility of submitting blood to the lab for a routine CBC and type and screen has been debated from a cost-benefit standpoint. In many centers, blood is drawn and simply held in case the patient’s course changes. If the decision is made to perform a cesarean delivery for an abnormal labor course, nonreassuring fetal testing, or abnormal bleeding, then the blood work is submitted.

Several situations can occur in which a CBC count and type and screen will be submitted upon admission to labor and delivery:

  • The patient is admitted for a planned cesarean delivery.

  • The patient is a grand multipara.

  • The patient has a history of postpartum hemorrhage or a bleeding disorder.


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