Abstract
References
- 1. Bertsias G, Cervera R, Boumpas DT. Systemic Lupus Erythematosus: Pathogenesis and Clinical Features. Eular Fpp Indd. 2012; 1:476-505.
- 2. Waters JH, Bonnet MP. When and how should I transfuse durnig obstetric hemorrhage? Int J Obstet Anesthesia. 2021; 46:3
- 3. Unlu A, Çetin A, Yenicesu İ, Ertuğruk N, Balas S- Ministry of Health, General Directorate of Health Services. Critical bleeding/ massive transfusion (Patient blood management guide- module 1). Retrieved from saglik.gov.tr
- 4. Balki M, Dhumne S, Kasodekar S, JCA Carvalho. Blood transfusion for primary postpartum hemorrhage: a tertiary care hospital review. J Obstet Gynaecol Can. 2008; 30:1002-7.
- 5. Chawla S, Bal MHK, Vardhan BS, Jose CT. Blood Transfusion Practices in Obstetrics: Our Experience. J Obstet Gynaecol India. 2018; 68(3):204-7.
- 6. Butwick AJ, Aleshi P, Fontaine M, Riley ET, Goodnough LT. retrospective analysis of transfusion outcomes in pregnant patients at tertiary obstetric center. Int J Obstet Anesth. 2009; 18 (4):302-8.
- 7. Stephens B, Sethna F, Crispin P. Postpartum obstetric red cell transfusion practice: A retrospective study in a tertiary obstetric centre. Aust N Z J Obstet Gynaecol. 2018; 58 (2):170-77
- 8. O'Brien KL, Shainker SA, Lockhart EL. Transfusion Management of Obstetric Hemorrhage. Transfus Med Rev. 2018; 32 (4):249-55.
- 9. Spahn DR, Goodnough LT. Alternatives to blood transfusion. Lancet. 2013; 381:1855-65.
- 10. Leahy MF, Hofmann A, Towler S, et al. Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion. 2017; 57:1347-58.
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- 12. Lasica M, Sparrow RL, Tacey M et al. Haematological features, transfusion management and outcomes of massive obstetric haemorrhage: findings from the Australian and New Zealand Massive Transfusion Registry. Br J Haematol.2020;190: 618-28.
- 13. Malhotra M, Sharma J, Batra S et al. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obstet. 2002; 79:93-100.
- 14. Vasudev R, Sawhney V, Dogra M, Raina TR. Transfusion-related adverse reactions: From institutional hemovigilance effort to National Hemovigilance program. Asian J Transfus Sci. 2016; 10 (1):31-36.
- 15. Santoso JT, Saunders BA, Grosshart K. Massive blood loss and transfusion in obstetrics and gynecology. Obstet Gynecol Surv. 2005; 60(12):827-37.
- 16. Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelletown: a cross sectional study. BMC Res Notes 2014; 7:888.
- 17. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006; 108:1039-47.
- 18. Holm C, Thomsen LL, Norgaard A and Langhoff-Roos J. Single-dose intravenous iron infusion versus red blood cell transfusion for the treatment of severe postpartum anaemia: a randomized controlled pilot study. Vox Sang. 2017; 112:122-31.
- 19. Ionescu A, Sharma A, Kundnani NR et al. Intravenous iron infusion as an alternative to minimize blood transfusion in peri-operative patients. Sci Rep. 2020;10: 18403.
- 20. Xie Y, Liang J, Mu Y et al. Incidence, trends and risk factors for obstetric massive blood transfusion in China from 2012 to 2019: an observational study. BMJ Open. 2021; 11(9):e047983.
- 21. Jackson DL, DeLoughery TG. Postpartum Hemorrhage: Management of Massive Transfusion. Obstet Gynecol Surv. 2018; 73(7):418-22
Abstract
Aim: To determine the incidence of obstetric massive blood transfusion in a tertiary center, to determine the characteristics of massive blood transfusion, its main causes and adverse outcomes in obstetric cases, thus trying to contribute to the creation of obstetric emergency plans.
Materials and methods: The results of 39 cases who underwent massive blood transfusion for obstetric indications were reviewed retrospectively. Demographic data of the cases (age, gravida, parity, body mass index), indications for hospitalization, vital signs during hospitalization, shock index, hemogram values and INR values, massive transfusion indications, transfused blood products (and in intensive care/intensive care units) from patient medical files. Length of hospital stay, reactions and complications related to massive transfusion were recorded.The cases who underwent obstetric massive blood transfusion were divided into 2 groups as low-risk pregnancy and high-risk pregnancy.The data were also compared between the 2 groups.
Results: The rate of massive blood transfusion was found to be 26 (12/4607) in 10000 pregnancies in low-risk pregnancies and 1.2% (27/2269) in high-risk pregnancies. Transfusion was started in 21 of 33 cases who underwent cesarean section due to massive bleeding that occurred intraoperatively. The time between the decision of transfusion due to obstetric hemorrhage and initiation of transfusion, and the vital signs and shock indices of the cases at the time of initiation of transfusion were similar between the groups (p>0.05). However, while the Hb and Htc levels were statistically lower in the low-risk group at the time of initiation of transfusion, the INR value was statistically higher in the high-risk group.
Conclusion: In massive obstetric hemorrhages, which is one of the most important causes of maternal mortality, application of surgical procedures (compression sutures, arter ligation or hysterectomy) combined with massive blood transfusion is life-saving.
Keywords
References
- 1. Bertsias G, Cervera R, Boumpas DT. Systemic Lupus Erythematosus: Pathogenesis and Clinical Features. Eular Fpp Indd. 2012; 1:476-505.
- 2. Waters JH, Bonnet MP. When and how should I transfuse durnig obstetric hemorrhage? Int J Obstet Anesthesia. 2021; 46:3
- 3. Unlu A, Çetin A, Yenicesu İ, Ertuğruk N, Balas S- Ministry of Health, General Directorate of Health Services. Critical bleeding/ massive transfusion (Patient blood management guide- module 1). Retrieved from saglik.gov.tr
- 4. Balki M, Dhumne S, Kasodekar S, JCA Carvalho. Blood transfusion for primary postpartum hemorrhage: a tertiary care hospital review. J Obstet Gynaecol Can. 2008; 30:1002-7.
- 5. Chawla S, Bal MHK, Vardhan BS, Jose CT. Blood Transfusion Practices in Obstetrics: Our Experience. J Obstet Gynaecol India. 2018; 68(3):204-7.
- 6. Butwick AJ, Aleshi P, Fontaine M, Riley ET, Goodnough LT. retrospective analysis of transfusion outcomes in pregnant patients at tertiary obstetric center. Int J Obstet Anesth. 2009; 18 (4):302-8.
- 7. Stephens B, Sethna F, Crispin P. Postpartum obstetric red cell transfusion practice: A retrospective study in a tertiary obstetric centre. Aust N Z J Obstet Gynaecol. 2018; 58 (2):170-77
- 8. O'Brien KL, Shainker SA, Lockhart EL. Transfusion Management of Obstetric Hemorrhage. Transfus Med Rev. 2018; 32 (4):249-55.
- 9. Spahn DR, Goodnough LT. Alternatives to blood transfusion. Lancet. 2013; 381:1855-65.
- 10. Leahy MF, Hofmann A, Towler S, et al. Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion. 2017; 57:1347-58.
- 11. Maternity care: what is needed for safer motherhood in the community? World Health Organization. Maternal Health and Safe Motherhood Programme. Safe Mother. 1992; 8:6-8.
- 12. Lasica M, Sparrow RL, Tacey M et al. Haematological features, transfusion management and outcomes of massive obstetric haemorrhage: findings from the Australian and New Zealand Massive Transfusion Registry. Br J Haematol.2020;190: 618-28.
- 13. Malhotra M, Sharma J, Batra S et al. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obstet. 2002; 79:93-100.
- 14. Vasudev R, Sawhney V, Dogra M, Raina TR. Transfusion-related adverse reactions: From institutional hemovigilance effort to National Hemovigilance program. Asian J Transfus Sci. 2016; 10 (1):31-36.
- 15. Santoso JT, Saunders BA, Grosshart K. Massive blood loss and transfusion in obstetrics and gynecology. Obstet Gynecol Surv. 2005; 60(12):827-37.
- 16. Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelletown: a cross sectional study. BMC Res Notes 2014; 7:888.
- 17. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006; 108:1039-47.
- 18. Holm C, Thomsen LL, Norgaard A and Langhoff-Roos J. Single-dose intravenous iron infusion versus red blood cell transfusion for the treatment of severe postpartum anaemia: a randomized controlled pilot study. Vox Sang. 2017; 112:122-31.
- 19. Ionescu A, Sharma A, Kundnani NR et al. Intravenous iron infusion as an alternative to minimize blood transfusion in peri-operative patients. Sci Rep. 2020;10: 18403.
- 20. Xie Y, Liang J, Mu Y et al. Incidence, trends and risk factors for obstetric massive blood transfusion in China from 2012 to 2019: an observational study. BMJ Open. 2021; 11(9):e047983.
- 21. Jackson DL, DeLoughery TG. Postpartum Hemorrhage: Management of Massive Transfusion. Obstet Gynecol Surv. 2018; 73(7):418-22
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 20, 2023 |
| Submission Date | August 22, 2023 |
| Published in Issue | Year 2023 Volume: 4 Issue: Supplemental Issue |
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