Incidence of Obstetric Massive Blood Transfusion and Clinicial Features: Hospital-Based Study

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.