Obstetric Transfusion Research Articles

Population rates of haemorrhage and transfusions among obstetric patients in NSW: A short communication

We estimated the population rates of obstetric haemorrhage and transfusion among women giving birth, utilising data collected in a review of the delivery admissions of 1200 randomly selected women in New South Wales in 2002. The estimated population obstetric haemorrhage rate was 13.1% (11.4% post-partum haemorrhage (PPH), 2.2% antepartum haemorrhage) and the transfusion rate was 1.06% (0.9% vaginal births, 1.6% of caesarean sections). When variations in definitions and denominators were accounted for, the difference in PPH rates among vaginal births (13.1%) and caesarean sections (6.3%) disappeared, suggesting PPH is under-ascertained for women delivered by caesarean section.

Blood transfusion in obstetrics: The pregnant women's point of view

SummaryThe objective of this study was to determine the views and compliance of a group of pregnant women regarding obstetric-related blood transfusion. In this prospective questionnaire-based analysis, a total of 300 pregnant women who attended the antenatal care clinic were included. The mean age and gestational age of patients were 31.6 years and 27.4 weeks, respectively. All demographic and questionnaire data were recorded and analysed. A total of 41% of participants were aware of the possible need for blood transfusion in pregnancy and 88% of all women would accept blood transfusion when necessary. The remaining 12% would refuse blood transfusion, even if it was life-saving, because of the fear of blood transfusion complications. It is concluded that counselling and a management plan should be scheduled for pregnancy, and management protocols should be developed for women who refuse blood transfusion. Transfusion alternatives should be discussed with women who will not accept the allogenic blood transfusion.

Trends in Blood Transfusion in Obstetrics

Trends in Blood Transfusion in Obstetrics

Massive Blood Loss and Transfusion in Obstetrics and Gynecology

Massive perioperative or periparturitional bleeding occasionally occurs in obstetric and gynecologic patients. Placenta previa, uterine atony, and ectopic pregnancy are just a few examples of many conditions that could predispose patients to significant blood loss. Therefore, it is important for physicians specializing in obstetrics and gynecology to be proficient in managing episodes of massive hemorrhage and the practice of the most commonly used blood components. We review and update the management of massive hemorrhage for obstetrics and gynecologic patients. In addition, we explore blood component therapy, its risks and benefits. Obstetricians & Gynecologists, Family Physicians Learning. After completion of this article, the reader should be able to explain the necessity of being proficient in managing episodes of massive hemorrhage, list the indications for use of various blood components, and summarize the risks and benefits of blood component therapy.

Uses and misuse of blood transfusion in obstetrics in Lagos, Nigeria.

The objectives of this study were to identify obstetric and medical conditions in transfused patients, appraise the justification for the transfusion and recommend measures for reducing transfusion in obstetrics in Nigeria. Available case records of obstetric patients transfused at the Lagos University Teaching Hospital between the period 1st November 1995 and 31 October 1998 were reviewed retrospectively. Data collected included booking status, mode of delivery, amount of blood-transfused, post transfusion packed cell volume (PCV), and obstetric and medical conditions found in the patients. There were 4,159 cases out of which 503 were transfused. The overall transfusion rate was 12.1%, in booked and unbooked patients, it was 6.6% and 45.8% respectively. Only 231 cases were available for full analysis, mean age was 28.9 +/- 5.2 years (range 16-43 years). Sixty-three (27.3%) had unit-transfusions. Mean post transfusion PCV was 28.4% +/- 4.3% (range 17%-43%). In 63 (27.3%), the post transfusion PCV was above 30%. Some of the obstetric and medical conditions in the transfused patients were caesarean section (68.8%), previous caesarean section (20.4%), antepartum haemorrhage (16.9%), pregnancy induced hypertension (15.6%), anaemia and malaria (14.0%), induction of labour (13.0%), ruptured uterus (8.8%), and sickle cell anaemia (5.2%). Multi-unit transfusions were found in ruptured uterus (5.8 units), sickle cell anaemia (4.9 units), vaginal and cervical lacerations (4.0 units), forceps delivery (3.9 units) and malaria and anaemia (2.9 units). The study shows a high transfusion rate; an appreciable number were unnecessary transfusions. A number of the obstetric and medical factors for blood transfusion were avoidable. A reduction in blood transfusion rate can be achieved by the provision of adequate, available and affordable maternal health services in Nigeria.

Adverse maternal outcomes in multifetal pregnancies

In this retrospective cohort of 165,188 singleton pregnancies and 44,674 multiple-fetal pregnancies in Canada from 1984 to 2000, we compared the incidence of maternal complications. Multiple gestation pregnancies were associated with significant increases in cardiac morbidity, haematologic morbidity, amniotic fluid embolus, pre-eclampsia, gestational diabetes, postpartum haemorrhage, prolonged hospital stay, the need for obstetric intervention, hysterectomy and blood transfusion. Multiple gestation pregnancies are associated with an increased risk of morbidity for the mother. This should be taken into consideration in antenatal care of these women.

Urticarial reactions in obstetric transfusion in Maiduguri, north east Nigeria

A total of 135 obstetric patients who were first-time transfusion recipients at the University of Maiduguri Teaching Hospital were studied with respect to the incidence and clinical severity of urticarial transfusion reactions (UTR) in relation to the number of previous pregnancies. The overall incidence of UTR was 12.6%. Analysing the data with respect to the number of previous pregnancies the incidence of UTR were 0%, 0%, 3.8%, 8.3%, 21.7% and 37.5% among patients with 0.1, 2, 3.4 and 5 previous pregnancies respectively. However, all cases of UTR in the affected patients were clinically mild, manifesting with urticarial rashes and pruritus without any features of anaphylaxis. This data would suggest that the risk of UTR increases with the number of previous pregnancies. Therefore, multiparous patients need closer observation during transfusion therapy.

The incidence of blood transfusion in obstetrics

The transfusion experience for a 1-year period (1998) at a large district general maternity unit was reviewed retrospectively. There were 5266 deliveries and 128 women received a blood transfusion (2.4%). The commonest reason for transfusion was retained placenta and/or membranes (49%) with low postnatal haemoglobin (29.6%) and uterine atony (11.7%) being the next most frequent indications. The highest rate of transfusion (10%) was seen in women delivered by forceps and the lowest (1.3%) with normal deliveries. This rate is higher than those reported in the literature. A prospective review is indicated, in parallel with the development and distribution of good practice guidelines.

Blood transfusion in obstetrics and gynaecology.

Blood transfusion in obstetrics and gynaecology.

Zur Vermeidung von Fremdbluttransfusionen in der Gynäkologie und Geburtshilfe

Public concern about the safety of transfusion was aroused by the discovery that the acquired immuno deficiency syndrome (AIDS) can be transmitted by blood transfusion. Patients who require transfusion are now apprehensive to the point of seeking alternatives or even refusing to receive blood. "Autologous transfusion" of the patients own blood can completely eliminate the risk of disease of transmission. Autologous transfusion can be accomplished in different ways: through intraoperative salvage and retransfusion of the patient's blood during surgery, and through donation by the patient of the required amount of blood before surgery. Intraoperative salvage is, to some degree at least, an alternative to transfusion of homologous blood for many surgical patients. Predepositing of blood is an alternative for patients whose elective surgery is scheduled far enough in advance (about 3 weeks) to permit deposit of the required amount of blood. Greater use of predonation would reduce the risk of hepatitis and other transfusion-associated illnesses. It should be noted that any transfusion in obstetrics and gynecology - autologous or homologous - may need a severe indication.

Hematologic problems in pregnancy: V. Obstetric transfusion therapy

A study of 37,186 admissions, from 1970 through 1974, to a large southern charity hospital obstetrics service revealed a striking 63 per cent reduction in number of patients receiving blood transfusions. Analysis showed no change in patient population, bleeding disorders, toxemia, incidence of obstetric hemorrhage, serious febrile morbidity, or incidence of antepartum anemia. In the study period cesarean section rate increased 77 per cent and anemia at delivery markedly decreased. Transfusions associated with spontaneous abortion decreased by 70 per cent, and after the third study year no patient undergoing legal abortion received blood. The study demonstrated improvement in specific hematinic therapy of antepartum anemia and avoidance of transfusion therapy in the presence of uncharacterized antepartum or puerperal anemia. Despite the remarkable decrease in blood transfusions, obstetric outcome (including perinatal mortality rate, maternal mortality rate, and serious febrile morbidity) did not suffer but, indeed, improved.

Intra-arterial transfusion in Obstetrics and Gynecology

Intra-arterial transfusion in Obstetrics and Gynecology

Continuous Drip Transfusion in Gynecology and Obstetrics

Continuous Drip Transfusion in Gynecology and Obstetrics

Continuous Drip Transfusion in Gynaecology and Obstetrics

Continuous Drip Transfusion in Gynaecology and Obstetrics

The use of blood transfusion in obstetrics and gynecology

The use of blood transfusion in obstetrics and gynecology

Transfusion in Obstetrics; Blood Matching as a Routine on Pregnant Patients

Transfusion in Obstetrics; Blood Matching as a Routine on Pregnant Patients