Retrospective Analysis of All Patients Undergoing Blood Transfusion in Obstetrics At A Tertiary Care Hospital, Belagavi- A Cross Sectional Study

Abstract

In the developing world, obstetric complications are the leading indications for blood transfusion. One common indication for blood transfusion in women is severe anaemia; the prevalence of which is highest in India, with half of the global maternal deaths due to anaemia. In the world, obstetric haemorrhage is the most common cause of maternal death. Access to compatible and properly processed blood is crucial in emergency obstetric care and to reduce maternal mortality. It has been observed that injudicious use of blood and blood products can lead to a number of complications in the recipients. Objectives: This study was conducted to know the various indications of blood transfusion (blood and blood products) in Obstetrics and to know transfusion reactions, if any. Design: Retrospective cross sectional study Setting: KLE Dr. Prabhakar Kore Charitable Hospital & Medical Research Centre, Belagavi Population: 204 pregnant and delivered women who received blood and blood product transfusion for any Obstetric cause from September 2014 to September 2015. Methodology: 204 women who received blood and blood product transfusion for any Obstetric cause from September 2014 to September 2015 were analysed to know the indications for transfusion and to know transfusion reactions. Results: 204 women received blood and blood products transfusion in this study. The indications for blood and blood product transfusion observed in our study were: Anaemia, Obstetric haemorrhage, HELLP, Thrombocytopenia, DIC, Ruptured ectopic, Ruptured uterus and others (Incomplete abortion, Complete abortion, Hyadatidiform mole and Persistent trophoblastic disease). Anaemia in pregnancy was the commonest indication and was observed in 121cases (58.45%) followed by Obstetric haemorrhage, which was seen in 40 cases (19.32%). The incidence of transfusion reactions was 4.41% (9 out of 204) in our study. Conclusion: A proper knowledge for blood and blood product transfusion is needed to avoid irrational use of the blood and blood products and thus making it available for people who are actually in need and also to decrease the economic burden. Anaemia still persists to be a major cause for blood and blood product transfusion. Obstetric haemorrhage is an emergency situation and cannot always be predicted or avoided. Thus, a well functioning blood bank is very essential to provide blood and blood products in the time of such emergencies. Packed red blood cells should be used in obstetric emergencies rather than whole blood for transfusion as whole blood leads to increased plasma volume, thus causing circulatory overload. Injudicious use of blood and blood products can lead to a number of complications in the recipients. The use of blood transfusions must be limited to an essential as it still causes a number of complications which are not negligible. Development of various strategies to avoid transfusion reactions is needed.