P.85 Re-audit of the management of blood product administration for major obstetric haemorrhage

Abstract

Introduction: Major obstetric haemorrhage (MOH) is a leading cause of morbidity and mortality worldwide accounting for 12.6% of direct maternal deaths in the 2015-17 MBRRACE-UK report. [1] Knight M, Bunch K, Tuffnell D et al. (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care-Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2015–17. Oxford: The National Perinatal Epidemiology Unit, University of Oxford 2020. Google Scholar Point-of-care (POC) testing (ROTEM/TEG) has been recommended by the RCOA, OAA and Association of Anaesthetists, to improve patient care, allowing cost-effective, real-time haemostatic resuscitation. Local hospital policy for MOH recommends 1:1 transfusion of RBC:FFP or as directed by TEG. Following a 2016 audit, [2] Niewiarowski J, Russell R. Management of blood product administration for major obstetric haemorrhage. OAA Obstetric Anaesthesia 2017. https://www.epostersonline.com/oaa2017/node/690?view=true Google Scholar a visual aid using TEG traces was designed to guide blood product replacement. Re-audit in 2018, [3] Niewiarowski J, Smith A, Russell R. Improving the management of blood product administration for major obstetric haemorrhage. Int J Obstet Anesth 2019;39/S1:S50. Google Scholar showed significant improvement in protocol adherence and led to the purchase of two TEG6 machines. This audit aimed to re-evaluate adherence to hospital guidelines and use of TEG6 to streamline transfusion of blood products.