Evaluation of blood reservation and use for caesaren sections in a tertiary maternity hospital in Pakistan

Background: in developing countries,obstetrical hemorrhage is the most common cause of maternal mortality. this disaster is avoided by the urgent blood transfusion and other life saving measures. in countries like pakistan many health care centers have very limited number of fresh and stored blood in their blood banks which causes lot of inconvenience to the management of bleeding patients. in obstetrical practice,blood transfusion is commonly done in caesarean section. aim: to order the optimal number of blood units to avoid unnecessary reservation so that blood stock do not get tie down and blood should be available to the deserving patients. methods: records of 1468 patients who had emergency and elective caesarean at the lady willingdon hospital lahore affiliated with king edward medical university lahore between 1st january and 30th june 2014 were reviewed data pertaining to age,parity,booking status,type and indication for caesarean section,pre-operative and post-operative packed cell volume,blood loss at surgery,units of blood reserved at blood bank,units of blood transfused and duration of hospital stay was extracted and data was analyzed. results: there were 3671 deliveries out of which 1468(40%) were by caesarean sections. during this study a total of 725 units of blood were reserved in the blood bank and later on these units of blood were made available to the operation theatre. only 145(20%) units of blood were transfused to 132 patients amongst those transfused 75(57%) were booked and 99(75%) had primary caesarean section. about 85% of those patients having transfusion had their primary section the most common indication for the transfusion was found to be the placenta previa (39 patients with 95 units of blood) and cephalo-pelvic disproportion(35 patients with 55 units of blood. conclusion: although a large number of units blood were reserved and made available to the operation theatre at the time of surgery,most the operated patients did had any transfusion. establishment of mini blood bank within the obstetrical unit will not only provide timely blood units supply but will also prevent unnecessary wastage of financial resources & blood in central blood bank.