The Impact of Anesthesia Type on Bleeding and Blood Transfusion Requirements in High-Risk Cesarean Sections

To evaluate the impact of the chosen anesthesia type on intraoperative and postoperative blood loss and blood transfusion requirements in cesarean sections for high-risk pregnancies. This retrospective cohort study included cesarean sections performed in high-risk pregnancies at Konya City Hospital between August 8, 2020 and December 31, 2024. Patients were divided into two groups: General anesthesia (GA) and Neuraxial anesthesia (NA). Preoperative and postoperative hemoglobin (Hb) and hematocrit (Hct) values were assessed, along with the administration of erythrocyte suspension (transfusion) for Hb <8 g/dL, length of hospital stay, and intensive care unit (ICU) admission. Statistical significance was set at p<0.05. Out of 14.450 cesarean sections performed during the study period, 125 cases diagnosed with high-risk pregnancy were retrospectively analyzed. Of these, 79 patients underwent surgery under GA and 46 under NA. While no differences were observed in preoperative Hb and Hct values between the groups, the GA group exhibited a significant decline in postoperative Hb (7.75±0.9 g/dL) and Hct (24.65±2.58%) (p<0.001). Blood transfusion was required in 82.6% of the GA group compared to 43% in the NA group (p<0.001). Additionally, the median hospital stay was 2 (2–3) days in the NA group versus 3 (3–4) days in the GA group, and ICU admission rates were 5.1% and 23.9%, respectively (p=0.002). In cesarean sections for high-risk pregnancies, patients receiving GA exhibited increased blood loss, higher transfusion requirements, and prolonged hospital stays compared to those receiving NA. These findings suggest that the choice of anesthesia significantly influences perioperative blood loss and transfusion needs.