A retrospective study of blood transfusion practices in obstetrics at Hassan Institute of Medical Sciences
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260764Keywords:
Blood transfusion, Postpartum hemorrhage, Anemia, Ruptured ectopicAbstract
Background: Blood transfusion is an integral component of obstetric care and an important indicator of maternal morbidity management. Obstetric hemorrhage remains a leading cause of maternal mortality worldwide. Common causes of transfusion in obstetrics include postpartum hemorrhage, antepartum hemorrhage, abortion, ectopic pregnancy, anemia, and coagulation disorders. Evaluating transfusion practices helps assess institutional quality of care.
Methods: A retrospective analysis was conducted of obstetric patients admitted to the OBG Department at Hassan Institute of Medical Sciences from 2021–2022. Data were obtained from blood transfusion registers, ICU and HDU admission records, anemia registers, and complication registers to evaluate transfusion indications and patterns.
Results: A total of 475 patients in 2021 and 435 in 2022 required blood transfusion, showing an 8.4% reduction in 2022. Anemia in pregnancy was the leading indication (39.8% in 2021; 36.8% in 2022), followed by abortion (22.9% and 25.3%). Postpartum hemorrhage accounted for 10.7% and 10.1% of cases, respectively. Overall, 706 units of blood products were transfused in 2021 compared to 649 units in 2022. Packed red blood cells constituted the majority of transfusions (78.7%), followed by platelet concentrates (10.2%) and fresh frozen plasma (8.6%).
Conclusions: Maternal anemia and obstetric hemorrhage remain the predominant indications for transfusion. Strengthening antenatal anemia management, early risk identification, and appropriate blood component therapy are essential to further reduce transfusion requirements and improve maternal outcomes.
Metrics
References
World Health Organization. WHO guidelines for the management of postpartum haemorrhage and retained placenta. Geneva: World Health Organization. 2009.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33. DOI: https://doi.org/10.1016/S2214-109X(14)70227-X
World Health Organization. Trends in maternal mortality 2000–2020. 2023. Available at: https://www.who.int/publications/i/item/9789240068759. Accessed on 12 January 2026.
Carson JL, Grossman BJ, Kleinman S, Tinmouth AT, Marques MB, Fung MK, et al. Red blood cell transfusion: clinical practice guidelines. JAMA. 2012;307(4):409-18.
Royal College of Obstetricians and Gynaecologists. Blood transfusion in obstetrics. Green-top Guideline No. 47. London: RCOG. 2015.
Butwick AJ, Goodnough LT. Transfusion and coagulation management in major obstetric hemorrhage. Curr Opin Anaesthesiol. 2015;28(3):275-84. DOI: https://doi.org/10.1097/ACO.0000000000000180
Patel VP, Shah PT, Patel KB, Shah SR, Mehta SR, Patel RD. Seasonal variation in blood utilization in obstetric practice. Asian J Transfus Sci. 2015;9(2):123-7.
Kalaivani K. Prevalence and consequences of anaemia in pregnancy. Indian J Med Res. 2009;130(5):627-33.
Bencaiova G, Burkhardt T, Breymann C. Anemia—prevalence and risk factors in pregnancy. Eur J Intern Med. 2012;23(6):529-33. DOI: https://doi.org/10.1016/j.ejim.2012.04.008
Bates I, Chapotera GK, McKew S, van den Broek N. Maternal mortality in sub-Saharan Africa: the contribution of severe anemia and blood transfusion requirements. Transfus Med. 2008;18(5):267-73.
Green L, Knight M, Seeney FM, Hopkinson C, Collins PW. The epidemiology and outcomes of massive transfusion in obstetrics: a UK population-based study. Br J Haematol. 2016;172(4):616-23. DOI: https://doi.org/10.1111/bjh.13864
Shields LE, Smalarz K, Reffigee L, Mugg S, Burdumy TJ, Propst M, et al. Comprehensive maternal hemorrhage protocols improve patient safety and reduce utilization of blood products. Am J Obstet Gynecol. 2015;212(3):272.e1-8.
Murphy MF, Stanworth SJ, Yazer M. Transfusion practice and safety in obstetrics. Vox Sang. 2011;100(2):111-26. DOI: https://doi.org/10.1111/j.1423-0410.2010.01366.x
Charbit B, Mandelbrot L, Samain E, Baron G, Haddaoui B, Keita H, et al. The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage. J Thromb Haemost. 2007;5(2):266-73. DOI: https://doi.org/10.1111/j.1538-7836.2007.02297.x
Patel A, Goudar SS, Geller SE, Kodkany BS, Edlavitch SA, Wagh K, et al. Drape estimation vs visual assessment for postpartum hemorrhage. Int J Gynecol Obstet. 2006;93(3):220-4. DOI: https://doi.org/10.1016/j.ijgo.2006.02.014