Adherence to Intravenous Access Recommendations for Cesarean Delivery

Cesarean delivery is the most commonly performed surgery worldwide.¹  Blood loss associated with cesarean delivery may be substantial and is the leading driver of parturient morbidity and mortality.²  Given this, intravenous (IV) access sufficient to permit intraoperative resuscitation and blood transfusion is necessary for safe parturient care.³  We assessed adherence to recommendations for minimal IV access for cesarean delivery and characterized patterns of adherence according to patient demographics and medical risk factors for severe blood loss.

We reviewed medical record data for all patients undergoing cesarean delivery on the labor and delivery unit of one urban academic hospital between April 1, 2023, and September 5, 2023. At our institution, labor and delivery nurses place the majority of IV catheters, with a catheter size of 20-gauge or larger considered to be acceptable. We excluded patients younger than 18 yr old, with pre-existing central venous access, and with missing...