PERİPARTUM VE POSTPARTUM KAN TRANSFÜZYONU YAPILAN HASTALARDA KLİNİK DENEYİMLERİMİZ

Year 2020, Volume: 51 Issue: 1, 31 - 34, 15.01.2020

Elcin İslek Secen , Mehmet Akif Sargın Esra Çamurşen İdris Yetimoğlu Özge Kaymaz Yılmaz Niyazi Tuğ

https://doi.org/10.16948/zktipb.500935

Cited By: 1

Abstract

Amaç:  Kliniğimizde
doğum yapan hastaların prepartum, peripartum ve postpartum dönemdeki kan ve kan
ürünleri transfüzyon endikasyonlarını literatür eşliğinde tartışmak.

Materyal-
Metod: Sancaktepe Şehit Prof.Dr.İlhan
Varank   Eğitim ve Araştırma Hastanesi,
Kadın Hastalıkları ve Doğum Kliniği,  01
Şubat 2018-31 Ekim 2018 tarihleri arasında doğum yapan ve kan transfüzyonu
yapılan hastaların demografik özellikleri, doğum kayıtları,  kan transfüzyonu zamanı, endikasyonları ve
sonuçlarının incelendiği retrospektif gözlemsel bir çalışma yapılmıştır.

Bulgular: Çalışma süresince kliniğimizde doğum yapan 3575 hastanın
kayıtları incelenmiştir. Hastaların %2,65’ine (n­:95) kan transfüzyonu yapılmıştır. Sezaryen ile doğumların
%5,41’ inde, vajinal doğumların ise %1,56’sında kan transfüzyonu uygulanmıştır.
Transfüzyon yapılan hastaların  %26,3‘inde
(n:25)  herhangi bir spesifik neden
belirtilmez iken %30,5 (n:29) hastada ek risk faktörü olmayıp transfüzyon
endikasyonu kronik anemi bulunmuştur. Obstetrik endikasyonlardan en sık uterin atoni
%18,9 (n:18)
saptanmıştır. Transfüzyon yapılan hastalarda kullanılanan kan ürünleriden
eritrosit süspansiyonu ortalama 2,09 ± 1,186 (0-7) ünite, TDP 1,49 ± 1,05 (0-4)
ünite uygulanmıştır.

Sonuç: Kan ve kan ürünleri transfüzyonları hayat kurtarıcı
tedaviler olmakla beraber istenmeyen komplikasyonlara da neden olabilirler.  Gebe hastaların izlem ve takiplerinin düzenli
yapılması sağlanarak uygun demir ve multivitamin takviyeleri ile gebelikte
anemiyi önleyerek transfüzyon oranlarının düşürülebileceğini düşünüyoruz. 

Keywords

Kan transfüzyonu, Gebelik, Obstetrik kanama

CLINICAL EXPERIENCE IN PERIPARTUM AND POSTPARTUM BLOOD TRANSFUSION PATIENTS

Abstract

Objective: We
aimed to discuss the indications of blood and blood products transfusion
in prepartum, peripartum and postpartum period who delivered in our obstetric clinic.

Materials –
Methods: A retrospective, observational study
was performed of the patients who were delivered
and received blood transfusion, at the Department of Obstetrics and Gynecology
of Sancaktepe Training and Research Hospital between 01 February 2018 - 31
October 2018. Data abstracted included demographic features, birth records, time of blood transfusions,
indications and results.

Results: During the study period, the records of 3575 patients who
delivered in our clinic, were examined. Blood transfusion was performed in
2,65% (n:95) of the patients. Blood transfusion was performed in 5,41% of
deliveries by cesarean section and 1,56% in vaginal deliveries. No
specific indications for transfusion were identified in 26,3% (n:25) of the patients and 30,5% patients  (n:29) had no risk factors except chronic anemia.
The most common obstetric indication  was
uterine atony 18,9% (n:18) of the patients. The red blood cells ratio used in
the transfused patients was 2,09 ± 1,18 (0-7) units, the fresh frozen plasma ratio
was 1,49 ± 1,05 (0-4) units.

Conclusion: Blood and blood products transfusions are life-saving therapies,
but they can also cause undesirable complications. We believe that transfusion rates
can be reduced by preventing the anemia in pregnancy with appropriate iron and multivitamin
supplements by ensuring the regular follow-up of pregnant patients. 

Keywords

Blood transfusion, Pregnancy, Obstetric hemorrhage

References

• KAYNAKLAR1.Gulumser C, Engin-Ustun Y, Keskin L, Celen S, Sanisoglu S, Karaahmetoglu S, Ozcan A, Sencan I. Maternal mortality due to hemorrhage: population-based study in Turkey J Matern Fetal Neonatal Med. 2018 Jun11:1-72. Balki M, Dhumne S, Kasodekar S, JCA Carvalho. Blood transfusion for primary postpartum hemorrhage: a tertiary care hospital review J ObstetGynaecol Can. 2008;30:1002–7.3. Chawla S, Bal MHK, Vardhan BS, Jose CTBlood Transfusion Practices in Obstetrics: Our Experience J Obstet Gynaecol India. 2018 Jun;68(3):204-2074. Butwick AJ, Aleshi P, Fontaine M, Riley ET, Goodnough LT. retrospective analysis of transfusion outcomes in pregnant patients at tertiary obstetric center. Int J Obstet Anesth. 2009 Oct;18(4):302-8.5. Shander A, Javidroozi M, Ozawa S et al. What is really dangerous: anaemia or transfusion? Br J Anaesth2011; 107(Suppl 1): 141–159.6. Lalonde A. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2012 May;117(2):108-187. American College of Obstetricians and Gynecologists Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol 2006;108:1039-47.8. Stones RW, Paterson CM, Saunders NJ. Risk factors for major obstetric haemorrhage. Eur J Obstet Gynaecol 1993;168: 1443–1448.9. Stephens B, Sethna F, Crispin P. Postpartum obstetric red cell transfusion practice: A retrospective study in a tertiary obstetric centre. Aust N Z J Obstet Gynaecol. 2018 Apr;58(2):170-17710. O'Brien KL, Shainker SA, Lockhart EL. Transfusion Management of Obstetric Hemorrhage. Transfus Med Rev. 2018 Oct;32(4):249-255.11.Carroli G, Cuesta C, Abalos E, Gulmezoglu AM. Epidemiology of postpartum haemorrhage: a systematic review. Best PractResClinObstetGynaecol. 2008 Dec;22(6):999-101212. Anderson JM, Etches D.Prevention and management of postpartum hemorrhage. Am Fam Physician. 2007 Mar 15;75(6):875-8213.Neill A, Thornton S. Secondary postpartum haemorr¬hage. J Obstet Gyanecol 2002;22:119-22.14. Centers for Disease Control (CDC). CDC criteria for anemia in children and childbearing- aged women. MMWR Morb Mortal Wkly Rep1989;38(22):400-4.15. World Health Organization. Iron deficiency anaemia assessment prevention and control: a guide for programme managers. Geneva: World Health Organization; 2001;132 16. Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelletown: a cross sectional study. BMC Res Notes 2014;7:888.17. Maternity care : what is needed for safer motherhood in the community? World Health Organization. Maternal Health and Safe Motherhood Programme. Safe Mother.1992;8:6-8. 18. World Health Organization. Worldwide prevalence of anaemia 1993 – 2005. WHO Global Database on Anaemia. Geneva: World Health Organization; 2008 19. Api O, Bayer F, Akıl A, Bektaş M, Api M, Dabak R, et al. The etiologic and demographicFactors related to anemia prevalence in the pregnant women admitting to an education and research hospital in Istanbul. Perinatoloji Dergisi 2009;17(1):28-33.20. Tunç SY, Görük NY, Ceylan B, Tunç N. The relationship between gestation and iron deficiency anemia in women applied to gynecologic outpatient clinic. J Clin Exp Invest 2012;38(1):49-52.21. Malhotra M, Sharma J, Batra S et al. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obstet 2002; 79:93–100.22. Vasudev R, Sawhney V, Dogra M, Raina TR. Transfusion-related adverse reactions: From institutional hemovigilance effort to National Hemovigilance program. Asian J Transfus Sci. 2016 Jan-Jun;10(1):31-623. Santoso JT, Saunders BA, Grosshart K. Massive blood loss and transfusion in obstetrics and gynecology. Obstet Gynecol Surv. 2005 Dec;60(12):827-3724. Treml AB, Gorlin JB, Dutton RP, Scavone BM. Massive Transfusion Protocols: A Survey of Academic Medical Centers in the United States Anesth Analg. 2017 Jan;124(1):277-28125. Bingham D, Lyndon A, Lagrew D, Main EK. A state-wide obstetric hemorrhage quality improvement initiative. Am J Matern Child Nurs. 2011 Sep-Oct;36(5):297-304 26. Vachhani JH, Joshi JR, Bhanvadia VM. Rational use of blood: a study report on single unit transfusion Indian J Hematol Blood Transfus. 2008 Jun;24(2):69-71