Evaluation of blood transfusions performed for obstetric and gynecological reasons in the tertiary hospital

M. F. Kıncı, Ezgi Karakas Paskal, Farida Hajibayli̇, Ercan Saruhan, Gokhan Pektas, A. A. Sivaslıoğlu
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Abstract

Blood transfusion is defined as the delivery of blood components and coagulation factor concentrates to a patient. About half of transfusions between the ages of 20 and 35 are performed in obstetrics and gynecology clinics. Electronic file records of 137 patients who underwent blood transfusion in Muğla Training and Research Hospital, Gynecology and Obstetrics Clinic between January 2014 and December 2018 were reviewed retrospectively. The demographic information of the patients, Hemoglobin and Hematocrit (before and after transfusion) values, and applied blood products and their amount were recorded. Of the patients who received blood transfusion, 79 were obstetric and 58 were gynecological patients. In obstetric cases, blood transfusion was most frequently performed after cesarean section (56.6%). Among the causes of transfusion, 43 (54%) patients had anemia after anemia, 10 (12.6%) patients had anemia after D/C, and 5 (6.32%) patients had uterine atony. Diagnostic dilatation/curettage (D/C) and total abdominal hysterectomy were performed in 12 (20.68%) of 58 patients, who were transfused for gynecological reasons, with the diagnosis of menometrorrhagia, while myomectomy was performed in 10 of these patients (17.24%), total laparoscopic hysterectomy was performed in 9 (15.51%) patients, urogynecological surgery and laparoscopic cystectomy were performed in 5 (8.62%) patients, and medical treatment was given with the diagnosis of menometrorrhagia. The preparation and use of blood and blood products should be approached in a multidisciplinary manner, covering many branches, especially Gynecology and Obstetrics and Hematology. Anemia prophylaxis should be initiated beforehand and post-operative transfusion should be reduced in pregnant women and patients who will undergo surgery. Unnecessary transfusions should be avoided in order to avoid complications that may occur during and after transfusion.
评价三级医院因产科和妇科原因输血情况
输血被定义为向病人输送血液成分和凝血因子浓缩物。在20岁至35岁的人群中,约有一半的输血是在妇产科诊所进行的。回顾性分析了2014年1月至2018年12月Muğla培训与研究医院妇产科门诊137例输血患者的电子病历记录。记录患者的人口统计学信息、输血前后血红蛋白和红细胞压积(Hematocrit)值、应用的血液制品及用量。接受输血的患者中,产科患者79例,妇科患者58例。在产科病例中,输血是剖宫产后最常见的手术(56.6%)。输血原因中,43例(54%)患者出现贫血后贫血,10例(12.6%)患者出现D/C后贫血,5例(6.32%)患者出现子宫张力不全。58例因妇科原因输血,诊断为月经过多的患者中,12例(20.68%)行诊断性扩张/刮除(D/C)和全腹子宫切除术,其中10例(17.24%)行子宫肌瘤切除术,9例(15.51%)行腹腔镜全子宫切除术,5例(8.62%)行泌尿妇科手术和腹腔镜膀胱切除术。诊断为月经过多给予药物治疗。血液和血液制品的制备和使用应以多学科的方式进行,包括许多分支,特别是妇产科和血液学。术前应预防贫血,术后应减少孕妇和将接受手术的患者输血。应避免不必要的输血,以避免输血期间和输血后可能发生的并发症。
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