Outcome of audit and education on blood transfusion practice in obstetrics setting

Kandasamy, Dhivya; Selvarajan, Aswin Kumar; Jeyakumar, Joshua Daniel

doi:10.1016/j.htct.2020.08.014

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…We found that the two most common indications for blood transfusion were uterine com-plications (especially uterine atony) and anemia. This is consistent with the findings of studies on transfusion practices in antenatal and postnatal patients conducted in developing countries (17,18).…”

Section: Discussionsupporting

confidence: 91%

“…Improving patient blood management in obstetrics and gynecology practices can be achieved through the training of updated standard guidelines on the appropriate utilization of blood components and regular audits of blood transfusion practices. This can be followed by active interventions to optimize therapeutic options in obstetric emergencies and prevent erroneous use of blood components (17). One limitation of the present study is that it was conducted on data collected from a single referral hospital, and the findings only give an insight into the patterns of blood and blood product utilization in pregnant women in this single tertiary care referral center.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, 40% of the cases received a single-unit transfusion. A review of the literature shows that the rate of single-unit transfusion ranges between 25% and 50% in both developing and developed countries (15)(16)(17). Some clinicians discourage the practice of single-unit transfusion.…”

Section: Discussionmentioning

confidence: 99%

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Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

et al. 2023

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Background: Effective blood transfusion is a life-saving practice in obstetrics and gynecology emergencies that can prevent blood product wastage in hospitals. Objectives: This study was performed to evaluate the appropriateness of the use of blood products in pregnant women in a tertiary care hospital in Zahedan, southeast Iran. Methods: This cross-sectional study was carried out from September 2019 to March 2020 to assess the patterns of blood utilization in a tertiary care hospital in Zahedan, Iran. Blood bank registries and the data of 1,500 pregnant women were used for data analysis, using blood transfusion indices, including cross-matched to transfusion (C/T) ratio, transfusion probability (T), and transfusion index (TI). Results: Out of 1,064 units of requested blood products, 581 (54.6%) were cross-matched, and 774 (72.7%) were transfused to patients. The blood transfusion indices of C/T, T%, and TI were 2.11, 48.48%, and 0.76, respectively. The transfusion rate was 6.2%, and the commonest associated obstetrics complication requiring transfusion was uterine atony (32.2%), followed by anemia (17.2%). There was a statistically significant relationship between the type of delivery, uterine and placental problems, coagulation disorders during pregnancy, number of deliveries, and residence place, and the probability of blood transfusion (P > 0.05). Conclusions: The overall blood utilization indices were encouraging; however, the proportion of blood wastage was relatively high. Regular auditing is needed to optimize the use of blood and blood products in obstetrics and gynecology departments.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

et al. 2023

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“…PRBC transfusion is not an uncommon practice in obstetrics. 21 Majority of the patients reported here had anti-E alloantibody. Finding antigen 'E' negative, 'K' negative red cell units for such patients is not tough as the incidence of 'E' antigen is nearly 20% and 'K' antigen is around 2% in blood donors.…”

Section: Discussionmentioning

confidence: 79%

Significance of red cell alloantibodies other than anti-D during pregnancy and their effect on the newborn: A case series

Nayak

2023

IJOGR

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Contrary to well-established guidelines in developed countries, awareness regarding red cell alloantibodies in antenatal period are lacking in India. Investigating for indirect antiglobulin test (IAT) is mostly limited to the Rh D negative antenatal cases. This case series revisits this vital aspect of maternal and fetal safety. Instances of alloantibody other than anti-D are reported.Study was done in Transfusion Medicine department of a tertiary care hospital in North India during 2019-2020. IAT was performed not during the 1st or 2nd trimesters of pregnancy but as a routine compatibility test during delivery. Patients with positive IAT were further evaluated for the detection of alloantibody by using identification panel red cells. Result: Eight antenatal cases with irregular antibodies other than anti-D during 2019-2020 are described. Antibodies detected per patient were single (three cases of anti-E, one of anti-Fya, one of anti-M) or multiple (two cases of anti-E plus anti-c, one of anti-E plus anti-K). Direct antiglobulin test of four babies born to these mothers was found to be positive, one of whom was still born and rest recovered with medical management. Two other babies had DAT negative and two mothers presented late after still birth. Alloantibody titer indicated in patient with anti-E during mid-pregnancy had titer was undetectable by standard tube technique.Non anti-D alloantibodies can potentially affect fetus, asserting equal attention as anti-D. IAT should not be missed in pregnancy as it is common to investigations for compatibility as well as for fetal wellbeing assessment.

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“…Prompt recognition of obstetric hemorrhage and immediate initiation of appropriate transfusion therapy are vital. Timely intervention helps stabilize the mother's condition, restore blood volume, and maintain tissue perfusion, thereby preventing severe maternal complications (15). The decision to initiate transfusion should consider the clinical necessity based on the severity of bleeding, hemodynamic instability, laboratory parameters, and the overall clinical status of the patient.…”

Section: Optimizing Maternal and Fetal Healthmentioning

confidence: 99%

Understanding Transfusion Therapy in Obstetrics: Ensuring Maternal and Fetal Health

E.I.,

G.U,

P.M.

2023

KJHS

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Transfusion therapy plays a pivotal role in obstetrics, serving as a critical intervention to address various maternal and fetal health challenges. The review encompasses the indications, types, and implications of transfusion therapy, aiming to provide a thorough understanding of its role in ensuring optimal outcomes for both mother and fetus. Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality globally. Transfusion therapy, involving the administration of blood and blood products, emerges as a cornerstone in the management of obstetric hemorrhage, offering a lifeline in critical situations. This abstract delves into the specific scenarios, such as postpartum hemorrhage and placental abruption, where timely transfusions are essential to prevent severe complications. Anemia, a prevalent concern in pregnancy, necessitates a nuanced approach to transfusion therapy. Understanding the thresholds for transfusion in the context of pregnancy-related anemia is crucial for balancing the benefits against potential risks. This review discusses the challenges in managing anemia, exploring the role of transfusion in alleviating symptoms and optimizing maternal and fetal health. In conclusion, this paper synthesizes the current knowledge on transfusion therapy in obstetrics, emphasizing its pivotal role in managing obstetric hemorrhage, anemia, and blood disorders. By elucidating the intricacies of transfusion therapy and its implications for maternal and fetal health, this review aims to guide healthcare professionals in making informed decisions, ultimately contributing to enhanced obstetric care and improved outcomes for pregnant individuals and their infants.

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Outcome of audit and education on blood transfusion practice in obstetrics setting

Cited by 6 publications

References 16 publications

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

Blood Transfusion and Associated Factors in Pregnant Women Admitted to a Tertiary Care Hospital in Southeast Iran

Significance of red cell alloantibodies other than anti-D during pregnancy and their effect on the newborn: A case series

Understanding Transfusion Therapy in Obstetrics: Ensuring Maternal and Fetal Health

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