Journal of AdvancedMedical and Dental Sciences Research

Background: According to World Health Organization (WHO), Haemorrhage constitutes 35% of deaths out of all global maternal mortality. Published data from the triennium 2008-2010 in South Africa indicate that if non-pregnancy-related sepsis is excluded, haemorrhage still ranks with hypertension as the most common cause of maternal deaths (24%). Labour and Welfare give little consideration to the pathophysiological mechanism or no standard for the appropriate dosage of blood product transfusion specific to obstetric hemorrhage. Therefore; we retrospectively reviewed blood product administration in patients with obstetric haemorrhage. Materials & Methods: Data was collected from January 1, 2012, and December 31, 2015 in which 252 obstetric patients underwent blood product transfusion in our tertiary perinatal institution. Their data were manually abstracted by our research staffs from our medical records, anonymized in an unlinkable fashion prior to our investigation, which exempted us from institutional review board approval. Blood products involved in this study are red cells concentrates (RCC), fresh-frozen plasma (FFP), and platelet concentrates (PC). Prothrombin activity was assayed by STA-R Evolution (Roche Diagnostics), a fully automated coagulation analyzer. Clotting times were converted to percent normal plasma prothrombin activity from a log-log standard curve prepared with dilutions of control pooled plasma. All the results were analyzed by SPSS software. Spearman’s rank correlation coefficient and Kruskal - Wallis one-way analysis of variance was used to assess the level of significance. Results: 252 obstetric patients who underwent blood product transfusion, consisting of over 65% delivered by Cesarean section and over 30 % delivered vaginally were included in the present study. More than 30% of women were transported to our institution in their puerperium for our specialized management of obstetric hemorrhage. The median of FFP/RCC ratio was not significantly different between underlying obstetric disorders, but 2.0 or more except for uterine atony. Conclusion: In cases of massive obstetric hemorrhage where appropriate supplementation of coagulation factors is essential, the transfusion of RCC: FFP = 1 : 1.3–1.4 is desirable
Key Words: Hemorrhage, Obstetric, Transfusion

Corresponding Author: Dr. Kanika Agarwal, Professor, M.D. Gynecology and Obstetrics, Mayo institute of medical Sciences, Barabanki, Uttar Pradesh, India

This article may be cited as: Agarwal K, Das G. Assessment of blood product administration in patients with obstetric hemorrhage: A retrospective analysis. J Adv Med Dent Scie Res 2016;4(6):12-16.