Comprehensive Maternal Health Protocol

Data were collected by two trained data collectors from the medical record, including prospectively collected baseline, obstetrics, and perioperative data of all mothers in the study hospital using a standardized checklist adapted from previous studies. A pre-test was performed on 5% of the sample size outside the study area.
Based on previous literature and clinical plausibility, we included a standardized set of information comprising pre-pregnancy information and clinical data on pregnancy-acquired and perioperative periods. The pre-pregnancy characteristics included maternal age, residency area, ANC visits, BMI, co-existing disease, and parity. Pregnancy-acquired characteristics included a previous history of abortion and abnormal uterine bleeding, current singleton or twin pregnancy, previous history of CD, prepartum anemia (< 11 g/dL), severe preeclampsia, eclampsia, HELLP syndrome, antepartum hemorrhage, induction/augmentation, and prolonged labor and perioperative data included types of CS, incision, types of anesthesia, birth weight, blood transfusion, and hemoglobin change. Hemoglobin difference was calculated by using hemoglobin values obtained during labor or within 24 h before CS and the postoperative period.