Maternal Outcome Among Women Undergoing Obstetric Massive Blood Transfusions

Abstract

Objective: To determine the maternal mortality and morbidity among women undergoing massive blood transfusion due to obstetric hemorrhage at tertiary care Hospital. Study Design: Cross-sectional study. Settings: Department of Gynaecology and Obstetrics Liaquat University Hospital, Hyderabad-Pakistan. Duration: 6 months from August 2016 to January 2017. Methodology: All the women undergoing massive blood transfusion due to obstetric hemorrhage were enrolled in current study. Women were followed during Hospital stay to measure the maternal morbidity and mortality. The data was documented in self-made pro-forma. Results: Total 115 women were studied, and mostly 69.6% were found in 20-30 years of age group and 30.4% in 31-40 years of age group. Majority of women 76.5% were un-booked. Multigravidas were most common 67.8%. Most of the patients 33.0% were noted with estimated blood loss more than 3000ml. Dilutional coagulopathy and thrombocytopenia were the most common complications among 26.1% patients respectively, followed by Hypocalcaemia, Citrate toxicity, Metabolic acidosis, Hypernatremia, Hypomagnesaemia, Renal failure, Blood reaction, Hyperkalemia and ICU admission with percentage of 18.3%, 6.1%, 13.0%, 11.3%, 8.7%, 6.1%, 9.6%, 7.0% and 13.9% respectively, while mortality rate was 7.0%. Conclusion: It was concluded that massive blood transfusion is very necessary for obstetric hemorrhage, but also correlated with greater rates of mortality and morbidity. The best massive blood transfusion protocols should be developed to decrease the complications.