EVALUATION OF BLOOD AND BLOOD PRODUCT UTILISATION PRACTICE IN OBSTRETICS AND GYNAECOLOGY – A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL

• Satyam Sarkar,  
• Iqbal Singh*

Abstract

Background: The most efficient utilization of blood in contemporary treatments reduces transfusion-related risks and enhances the management of blood inventories. It is essential to examine the present transfusion practices within Obstetrics and Gynaecology to guarantee that blood is utilized appropriately. The aim of this study was to evaluate the appropriateness of the use of blood and blood products in obstetrics and gynaecology at a tertiary care hospital. Materials & Methods: Over the course of 1.5 years, the study of obstetrics and gynaecology in-patients who sought blood transfusions was conducted. The information gathered on the clinical and blood transfusion data of the patients was examined for component consumption. Indicators of blood use were calculated and placed up against standard cut-off levels to determine the current transfusion practices. Results: In a study involving 330 obstetric in-patients for whom crossmatch requests were made, 60.6% (n=200) received blood transfusions with varying combinations of blood components. Anaemia (51.5%) was the most common reason for transfusion. Specifically, 39 units of red cells were used across 86 instances of Caesarean sections, resulting in a Crossmatch-to-Transfusion Ratio of 1.65. The study reported a Single Unit Transfusion Rate of 45%. Other blood components were also transfused, with 222 units of plasma used in 63 cases, 56 units of platelets used in 9 cases, and 3 units of cryoprecipitate used in 2 cases. According to the recommendations of the RCOG, 29% of the patients received units that were deemed unnecessary. Conclusion: Treatment of anaemia during pregnancy could decrease the frequency of single-unit transfusions. The misuse of blood components could be further minimized by refraining from transfusing patients with a hemoglobin level above 10 gm%. In a developing country like India, where the demand almost always exceeds the supply, the proper use of blood components is mandatory.

Keywords

crossmatch/transfusion ratio (C/T ratio), Transfusion Probability (%T), Transfusion Index (TI), anaemia.