Incidence and Indications of Transfusion of Blood and Blood Products among Women Admitted for Obstetric Care in a Tertiary Care Hospital: A Cross-sectional Study

Abstract

Background: The three main scourges which account for a majority of MMR are postpartum hemorrhage (PPH), preeclampsia, and sepsis. Postpartum hemorrhage remains most common direct cause for maternal mortality and the most common indirect causes are anemia, preeclampsia, and sepsis in India. The main objective of our study is to determine the incidence and indications of blood and blood products transfusion in women admitted for obstetric care and to assess the timing and type of transfusion. Materials and methods: Type of study: Cross-sectional Study The study was conducted in the Department of Obstetrics and Gynecology, Southern Railway Headquarters Hospital, Ayanavaram, Chennai, over 18 months between December 2017 and May 2019. The study area includes all the women admitted in antenatal, labor, postnatal wards, ICU, those seeking an abortion, and emergency inpatient services of obstetrics. Results: The incidence of blood and blood products transfusion was 2.4%. Postpartum hemorrhage followed by anemia complicating pregnancy is the commonest cause for the need for transfusion. Conclusions: Vigilant monitoring during the fourth stage of labor for early identification of signs and symptoms of ongoing acute bleeding in the diagnosis of obstetric hemorrhage is recommended. All pregnant women should be counseled regarding the intake of an iron-rich diet and factors affecting iron absorption, and compliance to oral iron supplementations so that hemoglobin could be optimized well in advance, thus avoiding a situation requiring blood transfusion. Each institute should have its transfusion protocol and audits which will aid in identifying triggers for transfusion, to ensure quality transfusion practices.