Observational study to analyse transfusion practices in obstetrics at tertiary care center in adult populations
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253076Keywords:
Anemia in pregnancy, Blood transfusion, Maternal mortality, Obstetric haemorrhage, Transfusion practicesAbstract
Background: Blood transfusion is one of the eight essential components of comprehensive emergency obstetric care and plays a critical role in reducing maternal mortality. Obstetric hemorrhage, particularly postpartum hemorrhage (PPH), remains a leading cause of maternal morbidity and mortality worldwide. Anemia and coagulation disorders further increase the risk of severe bleeding during pregnancy and delivery. The study aims at improving transfusion practices and also to deal with reactions associated with it.
Methods: A prospective observational study was conducted to evaluate obstetric patients who received transfusions. Data were collected on the type and indication of transfusion, components used, transfusion protocols followed, adverse reactions encountered, and maternal outcomes.
Results: The most common indications for transfusion were anemia, PPH, and placental causes such as placenta previa and abruption. Blood components commonly used included packed red blood cells (PRBCs), fresh frozen plasma (FFP), platelet concentrates, and cryoprecipitate. The majority of antepartum transfusions were for anemia correction, while postpartum transfusions were primarily due to hemorrhage. Adverse reactions were minimal but documented. Outcomes varied based on the condition and the promptness of transfusion.
Conclusions: Timely and appropriate transfusion of blood and its components is vital in the management of obstetric complications. Identifying high-risk patients and ensuring adequate blood component availability can significantly improve maternal outcomes and reduce mortality related to obstetric hemorrhage.
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References
Obaid TA. No woman should die giving life. Lancet. 2007;370(9595):1287-8. DOI: https://doi.org/10.1016/S0140-6736(07)61550-5
McLintock C, James AH. Obstetric hemorrhage. J Thromb Haemost. 2011;9(8):1441-51. DOI: https://doi.org/10.1111/j.1538-7836.2011.04398.x
Dutta DC. Dutta’s Textbook of Obstetrics. 9th ed. Hiralal Konar, editor. Hiralal Konar, Jaypee Brother’s publishers; 2014:303-311. DOI: https://doi.org/10.5005/jp/books/12044
Chhabra S, Namgyal A. Rationale use of blood and its components in obstetric-gynecological practice. J Mahatma Gandhi Insti Medi Sci. 2014;19(2):93-9. DOI: https://doi.org/10.4103/0971-9903.138427
Nunez TC, Young PP, Holcomb JB, Cotton BA. Creation, implementation, and maturation of a massive transfusion protocol for the exsanguinating trauma patient. J Trauma. 2010;68(6):1498-505. DOI: https://doi.org/10.1097/TA.0b013e3181d3cc25
O’Keeffe T, Refaai M, Tchorz K, Forestner JE, Sarode R. A massive transfusion protocol to decrease blood component use and costs. Arch Surg. 2008;143(7):686-91. DOI: https://doi.org/10.1001/archsurg.143.7.686
Alter HJ, Klein HG. The hazards of blood transfusion in historical perspective. Blood. 2008;112(7):2617-26. DOI: https://doi.org/10.1182/blood-2008-07-077370
Kawthalkar S. Whole blood, blood components, and blood derivatives. In: Kawthalkar S, editor. Kawthalkar’s Essentials of Hematology. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers (P) LTD; 2013:486-488. DOI: https://doi.org/10.5005/jp/books/11810_20
Nyflot LT, Sandven I, Stray-Pedersen B, Pettersen S, Al-Zirqi I, Rosenberg M, et al. Risk factors for severe postpartum hemorrhage: a case-control study. BMC Pregnancy Childbirth. 2017;17(1):17. DOI: https://doi.org/10.1186/s12884-016-1217-0
Prata N, Hamza S, Bell S, Karasek D, Vahidnia F, Holston M. Inability to predict postpartum hemorrhage: insights from Egyptian intervention data. BMC Pregnancy Childbirth. 2011;11:97. DOI: https://doi.org/10.1186/1471-2393-11-97
Al-Zirqi I, Vangen S, Forsén L, Stray-Pedersen B. Effects of onset of labor and mode of delivery on severe postpartum hemorrhage. Am J Obstet Gynecol. 2009;201(3):273.e1-9. DOI: https://doi.org/10.1016/j.ajog.2009.06.007
World Health organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage, 2012. Available at: https://iris.who.int/bitstream/handle/10665/75411/9789241548502_eng.pdf. Accessed 01 January 2025.
Abdul-Kadir R, McLintock C, Ducloy AS, El-Refaey H, England A, Federici AB, Grotegut CA, et al. Evaluation and management of postpartum hemorrhage: consensus from an international expert panel. Transfusion. 2014;54(7):1756-68. DOI: https://doi.org/10.1111/trf.12550
Carson JL, Hill S, Carless PA, Hebert PC, Henry D. Transfusion triggers: a systematic review of the literature. Transfus Med Rev. 2002;16(3):187-99. DOI: https://doi.org/10.1053/tmrv.2002.33461
Chahure S, Junnare K, Shekhawat GS. Blood transfusion practices in obstetric patients at a tertiary care institute during COVID-19 first wave: The need to re-strategize. Int J Clin Obstet Gynaecol. 2021;5(4):12-7. DOI: https://doi.org/10.33545/gynae.2021.v5.i4a.958
Rathod PA, Jadhao AN, Barapatre AR. Study of utilization pattern of blood and blood components in obstetrics at a tertiary care hospital. J Matern Child Health. 2022;7(5):591-9. DOI: https://doi.org/10.26911/thejmch.2022.07.05.10
Chawla S, Bal MHK, Vardhan BS, Jose CT, Sahoo I. Blood transfusion practices in obstetrics: our experience. J Obstet Gynaecol India. 2018;68(3):204-207. DOI: https://doi.org/10.1007/s13224-018-1092-x
Vasava DC, Thaker RV, Tyagi AA, Patel FP. Analysis of transfusion of blood and blood products and their utilization pattern at department of obstetrics of tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2020;9:261-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20196030
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