Retrospective Analysis for Causes of Perinatal Blood Transfusion

  Objective  To analyze the clinical factors related to perinatal blood transfusion, thus to assist clinicians in reducing perinatal hemorrhage.

  Methods  We retrospectively analyzed clinical records of 80 parturients who delivered and received perinatal transfusion at Peking Union Medical College Hospital in the period from January 2013 to December 2014, focusing on the correlation of blood transfusion with major pregnancy complications, calculating the rate and volume of blood transfusion, to elucidate the major risk factors contributing to postpartum hemorrhage and perinatal transfusion.

  Results  The mean age of parturients receiving blood transfusion was (29.8±4.8) years, and the mean gestational weeks at delivery was (35.6±4.3) weeks. The total blood transfusion volume was 503 U, including 293 U red blood cell suspension, 151 U plasma, and 59 U platelet. The blood transfusion rate was over 20% in the following conditions:HELLP syndrome (61.1%), pernicious placenta previa (57.1%), placenta accrete (57.1%), pregnancy acute fatty liver (57.1%), placental abruption (50.0%), hematologic diseases (41.2%), uterine inertia (40.7%) and severe preeclampsia (24.2%). The average blood transfusion volume was over 8 U in precipitate labor (15.0 U), pernicious placenta previa(14.0 U), placenta accrete (13.7 U), placental abruption (13.2 U), and acute fatty liver (9.6 U).

  Conclusions  Various pregnancy comorbidities and complications can lead to severe postpartum hemorrhage, even hemorrhage refractory to conventional measurements. Standard diagnosis and treatment of high-risk parturients, preventive procedure, timely detection of hemorrhage, and improved skills to control bleeding are the key to reducing postpartum hemorrhage, saving blood products, and to successful rescue in these emergencies.