Blood Transfusion Trends in Women With Abnormal Uterine Bleeding [14D

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INTRODUCTION: Blood transfusion continues to pose serious risks to recipients. The role of blood transfusion in management of women presenting with abnormal uterine bleeding is unclear and has not been studied before. The goal of this study is to determine the predictors of existing blood transfusion practice in women with abnormal uterine bleeding. METHODS: Retrospective chart review of women who presented to Emergency room between 2011 and 2013 with abnormal uterine bleeding and received blood transfusion. Patients with pregnancy, critical illness, cancer, bleeding diathesis and religious beliefs precluding transfusion were excluded. RESULTS: A total of 212 charts were reviewed. Of the women who received transfusion for abnormal uterine bleeding, 163 were between 24-60 yrs (73%), 141 were not on any hormonal therapy for bleeding (67%), 121 had no previous procedures performed (57%). 78 (37%) women were orthostatic, 21 (10%) had a hemoglobin less than 6 gm/dL, 170 (80%) had hemoglobin between 6-8 gm/dL. Patients with cardiac comorbidities were few (8%). Most women were African American (79%) and the most common etiology was Fibroids (71%). 164 (77%) women had chronic bleeding (6 months or more) and 48 (23%) had acute bleeding. 79 (37%) women had no insurance. CONCLUSION: Blood transfusion trends in women with abnormal uterine bleeding in the existing practice appear to be liberal. There is a need for prospective studies for implementing blood transfusion guidelines for women with abnormal bleeding and comparing outcomes of liberal versus restrictive transfusion practice in this clinical situation.