Evaluation of Uncross-matched Blood And Its Product Transfusion Practices In Obstetric Emergencies And Application of General Linear Model For Analysis

Marvi Arijo, Farah Shabi Ul Hasnain, Rabia Jamil, Tayyeba Anbreen

Abstract

Objective

To determine the frequency and outcome of uncross-matched blood in obstetric emergencies.

Study design

Cross sectional study.

Place & Duration of study

Department of Obstetrics & Gynecology Unit 2, Dr: Ruth K.M Pfau Civil Hospital Karachi & Dow University of Health Sciences (DUHS) Karachi, from November 2020 to April 2021.

Methodology

A total of 179 pregnant women who presented in emergency with any obstetric condition and required blood transfusion, were included. Data were collected on a pre-designed questionnaire and variables collected included gestational age, indication of blood transfusion, number and type of blood products transfused and others outcomes like length of hospital stay and death.

Results

The mean age of the women was 28.35±5.28 year. Frequency of uncross-matched blood transfusion in obstetric emergencies was 22.91% (n=41). The packed cell (n=32 - 78%) and fresh frozen plasma (n=23 - 56.1%) were most frequently transfused. Placenta abruption (n=15 - 36.5%), placenta previa (n=10 - 24.4%), placenta accreta (n=5 - 12%) and ruptured uterus (n=11 - 26%) were the commonest indications for uncross-matched blood in obstetric emergencies.

Mean hospital stay of women receiving uncross-matched blood was significantly high as compared to cross-matched blood transfusion (6.39±2.44 days vs. 3.18±0.65 days). Rate of ICU admission was also significantly high in same group. Mortality was also significantly high in  women with uncross-matched blood transfusion. The frequency of uncrossed-matched massive blood transfusion was significantly high in those women who had previous history of massive blood transfusion.

Conclusion

The frequency of uncross-matched blood transfused in obstetric emergencies was high. In the case of acute bleeding, the choice of transfusion should be based on clinical condition of the patient. A preplanned, multidisciplinary protocol gives best results in the management.

Key words

Obstetric hemorrhage, Obstetric emergency, Uncross-matched blood transfusion, Packed red cells transfusion, Fresh frozen plasma.