Blood Transfusion Practices in Obstetrics PT in a Tertiary Hospital

Background: Blood Transfusion is recognized as one of the eight essential component of comprehensive emergency obstetric care which has been shown to reduce the maternal mortality.1, 2 In developing country like India, efforts should be done to make blood and transfusion services well maintained and quickly available to reduce maternal morbidity from haemorrhage and thus decrease the incidence of maternal mortality. Accurate evaluation of blood loss is important to determine whether transfusion should be performed, but it is difficult in obstetric hemorrhage7, 8, 9. Transfusions decisions are clinical judgments that should be based on the overall clinical assessment. Aims and objective: To determine the incidence of Blood Transfusion in Obstetric cases and to evaluate the various indications for transfusion of blood and components in Obstetrics cases in the Department of Obstetrics and Gynaecology. Material and method: This prospective observational study conducted in the department of Obstetrics and Gynaecology NSCB Medical College & Hospital, Jabalpur m. p. during period of March 2019 to August 2021. Total 425 cases were included in the study. Results: maximum number of women studied were in the age group 20-30yrs (96.7%) followed by age group more than30 yrs (2.6%) and 0.7% women in age group less than 20yrs. majority of women were belonged to rural area (90.4%) and 9.6% belonged to urban area. majority of women were booked (97.4%) while 2.6% were unbooked.88.7% belonged to lower class, 10.6% belonged to middle class and 0.7% belonged to upper class.77.2% were multigravida and 22.8% were primigravida. majority of women had delivered vaginally 73.6%, 17.6% women had cesarean section, 2.6% had operative vaginal delivery, 4% underwent dilatation and curettage while 2.1% were subjected to exploratory laparotomy.322 (75%) women had require blood transfusion during antenatal period due to mod-severe anaemia and post natal require 94 (22%) and medical disorder such as thalessaemia and sickle cell ds which were1.2%. maximum women were transfused RCC were 328 (77.2%), 20.5% received RCC and FFP, 1.2% received RCC & CRYO & FFP, 0.7% transfused RCC & CRYO and 0.2% received CRYO and whole blood. no adverse reaction was found in majority of women of above 4 type of transfusion but proportion was higher in RCC as compare to that in FFP and whole blood and CRYOPPT. Conclusion: The transfusion practices though, have declined due to strict screening protocol and control procedures, yet a significant amount of blood/component transfusion have been seen in obstetric units. Severe anaemia postpartum hemorrhage is still a significant cause for transfusion in Obstetrics.component transfusion is the need of present day. Blood transfusion practices should be valid indication and there should be appropriate use blood/component transfusion therapy. Clinical significant: Ensuring a safe supply of blood and blood products and the appropriate and rational clinical use of blood are important public-health responsibilities of every national state government, especially for saving lives of mothers who need comprehensive emergency obstetrics care services because of antenatal severe anaemia with postpartum haemorrhage.