Study of role of blood transfusion in obstetric emergencies

Abstract

Background: Blood Transfusion is recognized as one of the eight essential component of comprehensive emergency obstetric care which has been shown to reduce the maternal mortality. 1,2 In developing country like India, efforts should be done to make blood and transfusion services well maintained and quickly available to reduce maternal morbidity from haemorrhage and thus decrease the incidence of maternal mortality. Aims & objectives: (1) To study clinical status of the patients at time of admission. (2) To study the role of antenatal visits in all patients required blood transfusion. (3) To study the effect of blood components on the patients' health. (4) To screen out the patients of high risk pregnancy and treat them safely. (5) To study causes of maternal mortality. Methods: Retrospective study of requirement of blood transfusion in antenatal and postnatal patients who came in labour room during last 3 month period at tertiary care Centre, Ahmedabad. Results: during the whole study out of 2200 patients 440 patients required blood transfusion among which 70% required due to obstetric hemorrhage and 30% due to severe anemia (less than 7 gm/dl). Major associated complications in the transfused patients were anemia (34%) and PPH (36%). 4 patients expired among them 2 were due to development of DIC and septicemia, 1 due to severe anemia and 1 due to severe PPH. Conclusions: Ensuring a safe supply of blood and blood products and the appropriate and rational clinical use of blood. Strategies made to maximize the haemoglobin (Hb) level at the time of delivery as well as to minimize blood loss. Active management of the third stage of labour is required to prevent avoidable morbidities, such as PPH, Retained product of conception, and vaginal lacerations.

Obstetric Emergencies and Transfusion Needs in a Nigerian Hospital

“…Coincidentally with the findings reported by Patel VP, et al [17] and Chhabra S, et al [18], this study also finds that hemorrhage and anaemia were the major indications for blood transfusion in the obstetric patients reviewed [17,18]. The overall transfusion rate of 2.2% is similar to the transfusion rate of 2.27% reported in Finland and falls within the range of 0.9 to 2.9% reported by Patel et al in Australia [7,17].…”

Role of blood and blood components transfusion in obstetric emergencies

“…This was also seen in another study, where 70% patients admitted as obstetrical emergencies, required blood and its components transfusion due to obstetric hemorrhage and 30% required blood and its components transfusion due to severe anaemia. 15 In another study done, 81% of blood transfusions were associated with obstetric haemorrhage. 16 The findings in this study are also in accordance with those reported by Chhabra et al, where obstetric hemorrhage and severe anemia were the major indications of blood and its components transfusion in obstetric emergency cases.…”

“…These findings were also seen in study by Patel VP et al, where PPH accounted for 36% of the cases and severe anemia accounted for 34% of the cases. 15 This can be attributed to the fact that the hospital is a tertiary care centre where patients with obstetric emergencies are mostly referred from peripheral hospitals. Anemia can be managed at peripheral hospitals but all cases of PPH with shock are mostly referred to this centre for further management because of unavailability of blood components at peripheral hospitals.…”

Analysis of transfusion of blood and blood products and their utilization pattern at department of obstetrics of tertiary care hospital

“…Patel VP et al, have reported 53 IUD and 27 neonatal deaths. 10 Single unit blood transfusion, literally has no meaning in obstetrics and thus should be avoided. Similarly, whole blood transfusion should be avoided as much as possible.…”