• C Holm, J Langhoff-Roos, K B Petersen, A Norgaard, and B R Diness.
• Department of Obstetrics, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark. charlotteholm@dadlnet.dk
• BJOG. 2012 Apr 1; 119 (5): 596-604.

ObjectiveTo examine the association between intended mode of delivery and severe postpartum haemorrhage.DesignA retrospective cohort study.SettingMaterial from a nationwide study in Denmark.PopulationDanish women giving birth in 2001-08.MethodsWe compared use of red blood cell transfusion by intended mode of delivery in the total population (n = 382 266), in low-risk nulliparous women (n = 147 132) and in women with a previous caesarean delivery (n = 25 156).Main Outcome MeasureRed blood cell transfusion within 7 days of delivery.ResultsIn the total population the crude transfusion rates for women with planned caesarean delivery and intended vaginal delivery were 2.24 and 1.75%. After adjustment for maternal age, body mass index, birthweight, smoking, parity, number of infants and previous caesarean delivery, the risk of red blood cell transfusion was significantly lower in women with planned caesarean delivery compared with intended vaginal delivery (odds ratio 0.82; 95% CI 0.73-0.92; P < 0.01). In low-risk nulliparous women and in women with a previous caesarean delivery the transfusion rates were lower for planned caesarean delivery compared with intended vaginal delivery before and after adjustment.ConclusionCompared with intended vaginal delivery, planned caesarean delivery was associated with a reduced risk of severe postpartum haemorrhage indicated by use of red blood cell transfusion.© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

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