Evaluation of blood transfusion practice in obstetrics and gynaecology at a tertiary hospital in Port Harcourt, Nigeria

Abstract

Background: Blood transfusion is an important part of patient management in obstetrics and gynaecology. There is a need to periodically assess blood transfusion practices in order to identify areas for improvement. Objectives: This study aimed to determine the rate of blood transfusion, indications, local use pattern, and variability of blood type transfused. Patients, Materials and Methods: A prospective observational study over six months was conducted at the Rivers State University Teaching Hospital. Obstetric patients in the peripartum period and gynaecological admissions who underwent blood transfusion were included. The patients' characteristics, blood type, pretransfusion packed cell volume (PCV), indication for transfusion, blood product used, number of pints, and donor group were recorded. Analysis was performed using SPSS version 23, and statistical significance was set at P < 0.05. Results: Overall, 84 out of 1000 patients were transfused, giving a rate of 8.4%, 7.4% in obstetric patients, and 13% in gynaecological patients. Haemorrhage was the main reason for transfusions in obstetrics 40 (65.6%), made up of postpartum haemorrhage 27 (44.3%) and antepartum haemorrhage 13 (21.3%), while antepartum anaemia was 17 (27.9%). In gynaecology, chronic anaemia was the main reason for transfusions 10 (43.5%), while acute haemorrhage was 7 (30.4%). Blood components used were whole blood 66.7% (56/84) and sedimented blood 33.3% (28/84) only. About a quarter of the patients who received blood transfusion, had a pretransfusion PCV of 25% or more (20/84) and received only one pint of blood (21/84). Conclusion: The rate of blood transfusion was relatively high, with gynaecology rates higher than obstetric. The indication for blood transfusion in obstetrics was mainly haemorrhage, while in gynaecology, it was chronic anaemia.