Critical audit of fresh frozen plasma transfusion practices in obstetric and gynecology departments in a tertiary care hospital – Where and what needs to be improved?

Abstract

Introduction: Fresh frozen plasma (FFP) prepared from whole blood contains plasma proteins and all the coagulation factors including factor V and factor VIII. Many FFP transfusion guidelines have been published till now. However, the administration is inappropriate without any scientific basis or clinical indication in many hospital settings. Aims and Objectives: A retrospective study was carried out between February 2016 and August 2016 in the regional blood transfusion center of our institution to assess the appropriate usage of FFP in obstetrics and Gynecology. It was done using the FFP transfusion guidelines based on the British Committee for Standards in Hematology and College of American Pathologists. Materials and Methods: Blood bank requisition forms received from patients of obstetrics and gynecology department during this period were screened. Indications for transfusion requests were studied and further divided into appropriate and inappropriate requests. Results: A total of 901 units of FFP were issued to 250 patients during this period. Appropriate usage of FFP was found in 67% and inappropriate usage in 33% of the 250 patients evaluated. Bleeding related to surgery with deranged coagulation profile constituted the most common appropriate indication for FFP infusion, and severe anemia was the most inappropriate indication for FFP use. Conclusion: The usage of FFP requires a proper understanding and knowledge about the appropriate and inappropriate usages. It also involves training and supervising the medical staff at regular intervals. Computerized audit programs are required to do a prospective monitoring of the FFP issue and usage in any clinical setting. Further studies are required on the usage of FFP specifically in obstetric and gynecology patients to improve the utilization of this precious blood product.

Keywords

• appropriate uses
• fresh frozen plasma
• obstetrics and gynaecology patients