KUMJ | VOL. 11 | NO. 4 | ISSUE 44 | OCT-DEC, 2013
Blood Transfusion in Obstetrics
Nigam A, Prakash A, Saxena P
Abstract: Transfusion of blood and blood components is a common practice in obstetric
wards but it is not without risk. The incidence of transfusion reactions varies from
4 in every hundred transfusions for non-haemolytic reactions to one in every
40,000 for haemolytic transfusion reactions. The physiological basis of blood
transfusion is outlined in this article. Most of the donated blood is processed into
components: packed red cells (PRBCs), platelets, and fresh frozen plasma (FFP)
or cryoprecipitate. Various alternatives to blood transfusion exist and include
autotransfusion, pre-autologous blood storage, use of oxygen carrying blood
substitutes and intraoperative cell salvage. Despite the risks associated with
transfusions, obstetricians are frequently too aggressive in transfusing blood and
blood products to their patients. Acute blood loss in obstetrics is usually due to
placenta praevia, postpartum blood loss and surgery related. An early involvement
of a consultant obstetrician, anaesthetist, haematologist and the blood bank is
essential. There are no established criteria for initiating red cell transfusions and
the decision is purely based on clinical and haematological parameters, which have
been discussed along with the general principles of blood transfusion in obstetrics
and some practical guidelines.
Keyword : Cryoprecipitate, fresh frozen plasma, packed cells, platelets
