Do we need routine complete blood count following vaginal delivery?

Routine post partum complete blood count examination (CBC) is customary in many medical centers. The rationale behind drawing a routine CBC is to estimate blood loss during delivery and to identify patients who will need blood transfusions. The present study was aimed to determine the necessity of routine post-partum CBC following vaginal delivery. A retrospective cohort study was performed including all patients who received blood transfusions following vaginal delivery between January 2003 and November 2004. Data were collected from birth files. The indications for administration of blood transfusions were noted. Of 20,694 vaginal deliveries, 0.7% (n=138) received blood transfusions. All patients had at least one obstetric risk factor of postpartum hemorrhage or symptomatic anemia. None received the blood transfusion based upon postpartum CBC hemoglobin level alone. Routine postpartum CBC is not warranted for the purpose of identifying the patient in need of blood transfusions. Postpartum CBC should be performed when indicated according to risk factors for excessive blood loss or patients' complaints.