PERİPARTUM VE POSTPARTUM KAN TRANSFÜZYONU YAPILAN HASTALARDA KLİNİK DENEYİMLERİMİZ

Öz

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. 

Anahtar Kelimeler

• 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

Kaynakça

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