Blood Transfusion Essay

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Blood transfusion practices in patients having caesarian section. A prospective multicenter survey. Introduction: There has been a dramatic rise in the rate of caesarean section (CS) in the last two decade making it the most commonly performed procedure worldwide. 1Surveys (2, 3) have indicated that 3-5% of total red cells transfusion is related to obstetrics with higher rate in CS patients compared to those having vaginal delivery (1-7% versus 1%) (4, 5). Transfusion in CS needs special consideration as this procedure is carried out in relatively young patients who are usually free of serious co-morbidities and have approximately four to five decades of lifetime in front of them. Ideally these patients do not need replacement with blood, as long term complications of allogeneic transfusion have a bigger impact on them (23). In recent years there has been an increase awareness regarding the potential risk of blood transfusion leading to increase scrutiny of its use by health care providers. (6). Studies have shown that by 1990s, the transfusion for CS has decreased to 1.1-1.6 % (7, 8) in some centers but remained relatively high (5.2-6.8%) in others (9, 10).Review of the available literature shows that need for transfusion varies in various countries. (11-14) Much of the existing data on cesarean section transfusion is retrospective and related to developed countries. (15, 16).In Pakistan, few studies have been conducted on this topic. A small retrospective study, done in a University hospital in Karachi on 126 patients undergoing caesarean section found transfusion rate of 15%. (17) This study was not reflecting a larger proportion of patients from our country as blood transfusion practices vary in different institution depen... ... middle of paper ... ... identification and rectification of the factors leading to this high transfusion rate. We identified CS as the most common factor requiring blood transfusion, highlighting the need to curtail the rate of CS. Being a third world country with limited resources, we recommend the need for national guidelines for the process of blood transfusion in the obstetric patients. The ordering physician should follow these guidelines depending upon the patient’s status at that point in time. The importance of discussion and taking the informed consent lies in a fact that process must be more systematic and covers the medico legal aspects as well. As anemia is quiet prevalent in our obstetric population it is also very important to use the strategies for treating the anemia during pregnancy, which may reduce the chance of blood transfusion (5 of f) in the perioperative period.

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