Correlation between maternal serum erythropoietin level and blood loss during cesarean section in pregnant women with placenta previa

Correlation Between Maternal Serum Erythropoietin Level and Blood Loss During Cesarean Section in Pregnant Women with Placenta Previa Purpose: We aimed to compare the amount of bleeding and transfusion needs of patients diagnosed with placenta previa and placenta accreata spectrum (PAS) during their surgery and to see whether there is a correlation between these bleeding parameters and the amount of erythropoietin (EPO) that we will check in the preoperative period. Material and Method: A total of 100 patients, including pregnant women diagnosed with placenta previa/PAS and the control group, who were admitted to Karadeniz Technical University Faculty of Medicine, Department of Gynecology and Obstetrics and delivered by cesarean section, between 2022 and 2024, were included. Separate patient follow-up forms were created for all individuals included in the study and demographic data were recorded. EPO levels were measured by taking blood from the patients preoperatively. In addition, data to show the amount of peroperative bleeding, such as the number of sponges, the number of compresses, and the amount of blood in the aspirator, were recorded. Results: The average age of the 100 participants included in the study was found to be 31,9 ± 5,3 years. In the pairwise comparison of the groups, a statistically significant difference was observed between the control group and the PAS group in terms of mean age (p<0.05). In the pairwise comparison of the groups in terms of the number of previous curettages, a statistically significant difference was observed between the control group and the PAS group and between the placenta previa group and the PAS group (p<0.05). A statistically significant difference was observed in the intergroup comparison of the number of cesarean sections the patients had undergone (p<0.05). The average preoperative EPO value of all patients was 27,5 ± 24,8. Preoperative EPO values of the patients were observed as 22.8 ± 18.4 in the control group, 32,6 ± 27,2 in the placenta previa group, and 31,6 ± 35,4 in the PAS group. A statistically significant difference was observed in the intergroup comparison of the patients preoperative EPO values (p<0.05). A statistically significant difference was observed v in the intergroup comparison of the number of sponges used peroperatively by the patients, the number of compresses, and the amount of blood in the aspirator (p<0.05). No statistically significant correlation was found between preoperative EPO levels and parameters indicating bleeding level in the cases participating in the study (p>0.05). Conclusion: We attribute the lack of significant correlation between the parameters specified in our study and EPO levels to the relatively small number of cases in our study. We believe that this study will inspire many studies to be conducted in the future. In this way, we think that the relationship between EPO and bleeding parameters can be revealed more clearly through randomized controlled studies and large series studies in more than one center. Keywords: Erythropoietin, Placenta Accreta Spectrum, Placenta Previa