Blood transfusion practices in obstetrics and gynecology: study of indications as a measure to prevent maternal morbidity and mortality
Keywords:Blood transfusion, Blood components, Indication of blood transfusion
Background: This is a study of rational use of blood transfusion in a tertiary care center. So, this study was done to find out the indications of blood transfusion in department of obstetrics and gynaecology and measures to minimize the requirement of blood transfusion to reduce maternal mortality and morbidity.
Methods: This is a retrospective study in department of obstetrics and gynaecologyin Muzaffarnagar Medical College, Muzaffarnagar, U.P. in collaboration with the department of pathology including blood bank for the duration of 1 year i.e. 1st January, 2017 to 31st December, 2017. Total transfusions in 1 year were 706 of which 406 were in obstetrics and 300 were in gynecology.
Results: In our study maximum 16.20% blood transfusions were given during cesarean section in third trimester in unbooked cases who came with severe anemia in labour. Others were APH (12%) and abortions (13.05%). This shows that anemia is still a major cause of maternal mortality and morbidity in India. In Gynecological cases blood transfusion was more in third parity and above indicating that perimenopausal women were also more susceptible for anemia due to disease of perimenopausal age group like AUB and fibroid.
Conclusions: Maximum number of transfusions specially PRBC in obstetrics were of moderate to severe anemia, mainly to the patients who were term or in labor and of high-risk pregnancies, who were unbooked with no antenatal care. In Gynecology cases, blood transfusion was of perimenopausal or menopausal group with moderate anemia. This comes to the conclusion that all preventive measures should be taken in females from womb to tomb to correct anemia and this will indirectly help to prevent maternal and perinatal morbidity and mortality.
Royal College of Obstetrician and Gynecologists- Blood transfusion in obstetrician. Green Top Guideline No. 47; 2015.
Parker J, Thompson J, Stanwarth S. A retrospective one year single centre survey of red cell transfusion. International journal of obstetrics anaesthesia. 2009;18:309-13.
Clark V, Waters JH. Editorial- Blood transfusion; more is not necessarily better. International Journal of obstetrics Anaesthesia. 2009;18:299-301.
Sweeney JD. Can physician prescribing pattern really be influenced and are there obstacles? International journal of obstetrics anaesthesia. 2009:39(2):139-44.
Chawla S, Bal MHK, Vardhan BS, Jose CT, Sahoo I. Blood transfusion practices in obstetrics: a prospective observational study, Dept of obstetrics and gynaecology in Armed forces medical college, Pune. J Obstetr Gynaecol. 2018;68(3):204-7.
Kawthalkar A, Kose V, Joshi S, Bhalerao A, Kumare B, Somalwar S. Blood transfusion in obstetrics and gynaecology. A retrospective analysis (original research) panacea. J Medic Sci. 2015:5(3):109-12.
Carson JL, Hill S, Carless P. Transfusion triggers: a systematic review of the literature. Transfus Med Rev. 2002;16(3):187-99.
Matsunaga S, Seki H, Ono, Y. A retrospective analysis of the transfusion management for obstetric haemorrhage in a Japanese Obstetric Center. ISRN Obst Gynecol. 2012:854064.
Gupta A, Manchanda GS, Sharma P, Sharma VK. Transfusion audit in a tertiary care hospital (original article) Department of Pathology, Muzaffarnagar Medical College and hospital, Muaffarnagar. Indian J Basic Applied Medic Res. 2018;8(1):467-72.
Chabra SL, Gyal AN. Rationale use of blood and its components in obstetric- gynaecological practice. J Mahatma Gandhi Institute of Medic Sci. 2014;19(2).
Snehalata C. Gupta and Pratima N Patil. Blood transfusion practice in obstetrics and Gynaecology; Impact of Educational programes to create awareness for judicious use of blood components. J Hematol Blood Transfusion. 2014;30(3):175-9.
World Health Organisation Blood Transfusion Safety Geneva. The clinical use of blood Handbook.