Marroquin Guillermo, Nicolae Tudorica, Hecht Robert and Magdy Mikhail
Objective: Compare the Estimated Blood Loss (EBL) between residents performing primary cesarean sections based on their level of training and their associated variables, including the combination of surgeon and assistant experience, demographic variables and different techniques in the procedure. Methods: Retrospective analysis of patients who had a primary cesarean section performed by residents from the Obstetrics and Gynecology Residency Program that attended the Labor and Delivery between August 2011 through December of 2012. 278 patients were included. Demographic and pertinent data was extracted from patient’s electronic medical record. The surgeons and assistants were categorized depending on their level of training in the residency program (Post Graduate Year [PGY]1,2,3,4). Results: 278 patients were included in the study, of them 133 were considered emergent cesarean sections mean cEBL of 832 ± 490, 74 urgent with 829 ± 513 cc, 67 scheduled with 884±167cc and 4 elective with 825 ± 52cc with with an observed Estimated Blood Loss (oEBL) of 873cc ± 182, change in hematocrit of 5.14& ± 3.13 and a calculated (cEBL) of 832.5 ± 490 cc. time in minutes was different between 1 and 2 layers closure (57.4 vs. 67.7 minutes) and their cEBL 734 vs. 662cc. Conclusions: There is a difference in cEBL and change in hematocrit in primary cesarean sections done by residents based on their surgical experience. Time, cEBL, change in Hto is influenced by the years of training of the surgical team. Higher BMI was associated with more surgical time and change in Hto. 2 layer closures were found to consume more surgical time.