Anyone review OB - specifically L&D?

We have recently begun reviewing L&D charts and I am debating with myself about ABLA. The C-sections will sometimes have a 2 to 3 point drop in Hgb. The Hgb is done pre-delivery and checked the day after delivery - this is routine. The EBL is WNL for a C/S. They are asymptomatic, VSS, no treatment is given and no further labs are checked. Is a query for ABLA appropriate?

Same scenario as above and the physician documents "anemia" on DS. Is query for type of anemia appropriate?

Comments

  • We only query if it required additional monitoring in  the form of labs outside of the routine pre/post op, if treatment was given which may include discharging on Iron supplements or transfusions, length of stay is extended due to Acute Blood Loss Anemia. You have to keep in mind that most of these women receive a lot of IV fluids and the drop could be dilutional.

  • I agree with Lucy. I would want to see more than a drop in H&H. Pregnant women have higher red cell counts as the body's way to prepare for delivery. Check with your OB nurses if you want to better understand the clinical piece.

  • Thank you for the input. It is greatly appreciated!

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