Blood requisition and utilization practice in obstetric patients at tertiary care center from South India: A descriptive study

Abstract

BACKGROUND: Although blood ordering is a common practice in surgical field, in obstetric patients too requests are commonly made to crossmatch units of blood for patients in whom bleeding is anticipated and to provide precautionary cover for cesarean section. This was a prospective study on blood requisition and utilization practice among obstetric patients at our center. METHODS: Data collection pro forma was used to collect information from antenatal case notes on demographics, transfusion request, units transfused, reason for transfusion, and related laboratory data. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) indices for all obstetric conditions. The maximum blood ordering schedule (MBOS) was used to develop algorithm for obstetric conditions. RESULTS: The incidence of red blood cells transfusion among all obstetric admissions was 708 out of 17275 (4.1%). Only 18% of blood requested for obstetric patients actually received transfusion. The overall C/T ratio, transfusion probability, and TI in obstetric patients during the study were 3.5%, 19.3%, 0.35%, respectively. Transfusion algorithm by classifying all obstetric conditions into three categories was developed based on MBOS for obstetric indications at our center. CONCLUSION: Although blood was reserved for the most obstetric patients, majority of the patient did not require transfusion. Hence, a new blood reservation and pretransfusion policy were recommended to minimize overordering and needless operating expenses for blood banks.

Keywords

• Blood transfusion
• blood utilization index
• crossmatch to transfusion ratio