Risk Factors Found in Most Obstetric Patients Who Require Transfusions


PALM DESERT, CALIF. — Just 9% of obstetric patients who required transfusions had no identifiable risk factors for hemorrhage in a study presented at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.

A review of medical records from 2002 and 2003 revealed that 27 of 14,813 patients who delivered vaginally and 44 of 3,844 patients who delivered by cesarean section required blood products, resulting in transfusion rates of 0.18% and 1.1% in vaginal and cesarean deliveries, respectively.

Among those obstetric patients who received a transfusion, more than a third of them had one risk factor, a third had two risk factors, and one in five of the patients had three risk factors, according to John T. Ratliff, M.D., a fellow in anesthesiology at Northwestern University, Chicago.

According to the study findings, the most common risk factor was chorioamnionitis, discovered in 17 of the patients. Some of the other risk factors included multiple gestation (12 patients), a prior uterine scar with no labor (9 patients), placenta previa (8 patients), placental abruption (8 patients), and accreta/percreta (9 patients).

Remaining risk factors included magnesium therapy, prior C-section after a vaginal trial of labor, intrauterine fetal demise, and pregnancy-induced hypertension.

“These data suggest that it might be possible to predict those obstetric patients at risk, and to establish criteria for crossmatching in this population,” wrote Dr. Ratliff in a poster that was presented at the meeting.

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