Sadia Kanwal, Kausar Jabeen, Saira Afghan, Rakhshanda Rashid, Syeda Batool Mazher.
Current blood transfusion practices in obstetrics & gynaecology at MCH Centre PIMS.
Ann Pak Inst Med Sci Jan ;1(4):238-41.

Subjects and Methods: All gynecological and obstetric admissions in MCH Centre Unit II during the study period that received or arranged blood or blood products were enrolled, and sub-categorized as gynecological and obstetric patients. Main outcome measures were total number of units arranged, transfused, and number of transfusions per patient and indications of blood transfusions, including unnecessary transfusions. Secondary outcome measures were immediate transfusion reactions and pre and post transfusion hemoglobin levels. Results: Total number of admissions during the study period was 1920, out of these 206 patients (10.7%) were advised to arrange blood and 166 (8.6%) patients received blood transfusions. Obstetric patients were 132 (64%), 114 patients arranged blood and 106 received transfusions. Transfusion rate was 7%. Total units arranged were 272, and units transfused were 244, number of transfusion per patient were 2.3 units. The two indications for transfusion were chronic anemia in 62(58.4%) patients and acute hemorrhage in 44(41.5%) patients. 28(26.4%) patients had unnecessary transfusions. Gynecological patients were 74 (35.9%), 60 patients received blood transfusion; transfusion rate was 14%. 112 units were arranged and 106 were transfused. Four units were transfused per patient. Acute hemorrhage was major indication for transfusion 47(78.3%), followed by chronic anemia 11(18.3%). Unnecessary transfusions were 14(23.3%). Three obstetric patients had immediate minor transfusion reaction. No major transfusion reaction was reported among gynecological patients. Mean pre transfusion Hb level of the patients was 8gm/dl (2.8-12.8gm/dI) and post transfusion Hb was 8.4gm/dl (5-12.4gm/dl). Conclusion: Transfusion rate in the unit was high, and a significant number of transfusions were un-necessary. There is need to improve transfusion practices. Regular transfusion audits should be carried out to identify areas of practice that can be improved. Indications and guidelines for appropriate use of blood should be developed and disseminated to various levels of health care.

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