Blood transfusion in obstetrics and gynaecology

Ekeroma, Alec; Ansari, A. H.; Stirrat, Gordon M.

doi:10.1111/j.1471-0528.1997.tb11454.x

Cited by 73 publications

(34 citation statements)

References 38 publications

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“…e homeostatic reaction to massive blood loss is in e ect in young patients having no medical problems, but poorly in elderly patients. 27,28 In our study, we found that indication of blood transfusion for delivery was noteworthy (25%) and most of our all patients were more than 35 years of age.…”

Section: Discussionmentioning

confidence: 74%

Distribution of indications for blood transfusion among the patients of Faridpur, Bangladesh

Biswas¹,

Biswas

Rassell

et al. 2016

Bangladesh Med J

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Section: Discussionmentioning

confidence: 74%

Distribution of indications for blood transfusion among the patients of Faridpur, Bangladesh

Biswas¹,

Biswas

Rassell

et al. 2016

Bangladesh Med J

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“…[9][10][11] The average risk of transfusion is variable in gynecology and ranges from 0.01% for operative hysteroscopy, 2-5% for operative laparoscopy, 0.3-11% for hysterectomy, 21% for myomectomy, and up to 78% for cytoreductive surgery. [12][13][14][15][16][17][18] However, the overall average risk of a woman requiring a blood transfusion after gynecologic surgery is low making routine testing a high-cost, low-value decision. Improving the accuracy of predicting a patient's specific risk requires the surgeon to incorporate known risk factors and crudely estimate whether the patient is lower, similar, or higher than these averages.…”

Section: Introductionmentioning

confidence: 99%

A model to predict risk of blood transfusion after gynecologic surgery

Stanhiser

Chagin

Jelovsek

2017

American Journal of Obstetrics and Gynecology

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BACKGROUND:A model that predicts a patient's risk of receiving a blood transfusion may facilitate selective preoperative testing and more efficient perioperative blood management utilization. OBJECTIVE: We sought to construct and validate a model that predicts a patient's risk of receiving a blood transfusion after gynecologic surgery. STUDY DESIGN: In all, 18,319 women who underwent gynecologic surgery at 10 institutions in a single health system by 116 surgeons from January 2010 through June 2014 were analyzed. The data set was split into a model training cohort of 12,219 surgeries performed from January 2010 through December 2012 and a separate validation cohort of 6100 surgeries performed from January 2013 through June 2014. In all, 47 candidate risk factors for transfusion were collected. Multiple logistic models were fit onto the training cohort to predict transfusion within 30 days of surgery. Variables were removed using stepwise backward reduction to find the best parsimonious model. Model discrimination was measured using the concordance index. The model was internally validated using 1000 bootstrapped samples and temporally validated by testing the model's performance in the validation cohort. Calibration and decision curves were plotted to inform clinicians about the accuracy of predicted probabilities and whether the model adds clinical benefit when making decisions. RESULTS: The transfusion rate in the training cohort was 2% (95% confidence interval, 1.72e2.22). The model had excellent discrimination and calibration during internal validation (bias-corrected concordance index, 0.906; 95% confidence interval, 0.890e0.928) and maintained accuracy during temporal validation using the separate validation cohort (concordance index, 0.915; 95% confidence interval, 0.872e0.954). Calibration curves demonstrated the model was accurate up to 40% then it began to overpredict risk. The model provides superior net benefit when clinical decision thresholds are between 0-50% predicted risk. CONCLUSION: This model accurately predicts a patient's risk of transfusion after gynecologic surgery facilitating selective preoperative testing and more efficient perioperative blood management utilization.

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“…There are no firm criteria for initiating red cell transfusion. 3 The decision to perform blood transfusion should be made on both clinical and haematological grounds. Blood transfusion is almost always required when haemoglobin is less than 6 gm% and it is rarely required when haemoglobin is greater than 10 gm%.…”

mentioning

confidence: 99%

Changing trends of blood transfusion requirement in obstetrics and gynaecology

Singh¹,

Anne²,

Ravindran³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: With the advent of the new pharmacological drugs and surgical advances compared to yesteryears, that the requirement of blood transfusion in obstetrics and gynaecology has decreased. Earlier obstetrical haemorrhage had been the commonest reason for blood transfusion. This trend seems to be changing. To evaluate this an observational study was done at a peripheral hospital to assess various indications for blood transfusion in maternity ward over a period of one year. Methods: A total of 129 transfusions were studied in a period of one year and requirement of transfusion was assessed by the same team of doctors as per AABB guidelines for blood transfusion. Results: A total of 87 obstetric patients required transfusion out of which 51.2% patients were transfused for anaemia near term. Postpartum haemorrhage constituted only 1.15% and ante partum haemorrhage only 4.6%. 17.24% of patients were transfused for incomplete abortion after taking medical abortion. 42 patients were transfused blood for various gynaecological reasons of which puberty menorrhagia constituted 19.01% and patients with perimenopausal bleeding were 28.57%.Conclusions: This study highlights the changing trends in requirement of blood transfusion and the need to emphasise on antenatal nutrition, supplements and contraception.

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Blood transfusion in obstetrics and gynaecology

Cited by 73 publications

References 38 publications

Distribution of indications for blood transfusion among the patients of Faridpur, Bangladesh

Distribution of indications for blood transfusion among the patients of Faridpur, Bangladesh

A model to predict risk of blood transfusion after gynecologic surgery

Changing trends of blood transfusion requirement in obstetrics and gynaecology

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