scholarly journals Mild Anemia and Risk of Postpartum Hemorrhage or Blood Transfusion in Preeclampsia

2022 ◽  
Vol 226 (1) ◽  
pp. S281-S282
Author(s):  
Richard M. Burwick ◽  
Rachel A. Newman ◽  
Monica Rincon
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Mild Anemia

The Impact of Obesity on the Management and Outcomes of Postpartum Hemorrhage

2020 ◽  
Author(s):  
Aleksandra Polic ◽  
Tierra L. Curry ◽  
Judette M. Louis
Keyword(s):  
Interventional Radiology ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Tertiary Care ◽  
P Value ◽  
Obese Women ◽  
Severe Morbidity ◽  
The Impact ◽  
To Receive

Objective The study aimed to evaluate the impact of obesity on the management and outcomes of postpartum hemorrhage. Study Design We conducted a retrospective cohort study of women who delivered at a tertiary care center between February 1, 2013 and January 31, 2014 and experienced a postpartum hemorrhage. Charts were reviewed for clinical and sociodemographic data, and women were excluded if the medical record was incomplete. Hemorrhage-related severe morbidity indicators included blood transfusion, shock, renal failure, transfusion-related lung injury, cardiac arrest, and use of interventional radiology procedures. Obese (body mass index [BMI] ≥ 30 kg/m2) and nonobese women were compared. Data were analyzed using Chi-square, Student's t-test, Mann–Whitney U test, and linear regression where appropriate. The p-value <0.05 was significant. Results Of 9,890 deliveries, 2.6% (n = 262) were complicated by hemorrhage. Obese women were more likely to deliver by cesarean section (55.5 vs. 39.8%, p = 0.016), undergo a cesarean after labor (31.1 vs. 12.2%, p = 0.001), and have a higher quantitative blood loss (1,313 vs. 1,056 mL, p = 0.003). Both groups were equally likely to receive carboprost, methylergonovine, and misoprostol, but obese women were more likely to receive any uterotonic agent (95.7 vs. 88.9%, p = 0.007) and be moved to the operating room (32.3 vs. 20.4, p = 0.04). There was no difference in the use of intrauterine pressure balloon tamponade, interventional radiology, or decision to proceed with hysterectomy. The two groups were similar in time to stabilization. There was no difference in the need for blood transfusion. Obese women required more units of blood transfused (2.2 ± 2 vs. 2 ± 5 units, p = 0.023), were more likely to have any hemorrhage-related severe morbidity (34.1 vs. 25%, p = 0.016), and more than one hemorrhage related morbidity (17.1 vs. 7.9, p = 0.02). After controlling for confounding variables, quantitative blood loss, and not BMI was predictive of the need for transfusion. Conclusion Despite similar management, obese women were more likely to have severe morbidity and need more units of blood transfused. Key Points

Embryo transfer is a risk factor for severe postpartum hemorrhage and blood transfusion requirement

2017 ◽  
Vol 32 (6) ◽  
pp. 879-882 ◽  
Author(s):  
Shohei Noguchi ◽  
Takeshi Murakoshi ◽  
Hiroko Konno ◽  
Mitsuru Matsushita ◽  
Minako Matsumoto
Keyword(s):  
Risk Factor ◽  
Blood Transfusion ◽  
Embryo Transfer ◽  
Postpartum Hemorrhage ◽  
Transfusion Requirement ◽  
Blood Transfusion Requirement

Response to ‘Postpartum hemorrhage and blood transfusion among parturients with scarred uterus-the evidence is there’

2019 ◽  
Vol 98 (4) ◽  
pp. 536-537
Author(s):  
Sarah Pont ◽  
Kathryn Austin ◽  
Ibinabo Ibiebele ◽  
Siranda Torvaldsen ◽  
Jillian Patterson ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Scarred Uterus

Blood Transfusion for Primary Postpartum Hemorrhage: A Tertiary Care Hospital Review

2008 ◽  
Vol 30 (11) ◽  
pp. 1002-1007 ◽  
Author(s):  
Mrinalini Balki ◽  
Sudhir Dhumne ◽  
Shilpa Kasodekar ◽  
Jose C.A. Carvalho ◽  
Gareth Seaward
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Cancer Related Anemia in the Era of Erythropoietin Stimulating Agents (ESA)Uncertainty: A Single Cancer Institution Experience.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5085-5085
Author(s):  
Hikmat Abdel-Razeq ◽  
Shadi B Hijjawi ◽  
Hazem Abdulelah ◽  
Yousef Ismael ◽  
Rula Amarin ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Combined Treatment ◽  
Disease Stage ◽  
Severe Anemia ◽  
Primary Cancer ◽  
Mild Anemia ◽  
Erythropoietin Stimulating Agents ◽  
Prevalence Of Anemia

Abstract Abstract 5085 Anemia is the most common hematological abnormality in cancer patients. Unfortunately, it is often under-recognized and under-treated. The pathogenesis of cancer anemia is complex and most of the time multifactorial; involving factors related to the tumor itself or its therapy. Recombinant human erythropoietin stimulating agents (ESA) was widely used to prevent and treat cancer and chemotherapy-related anemia. However, many recent studies involving patients with different kind of cancers at different stages of their disease suggested a negative impact on disease progression and survival when such ESA were used to keep Hemoglobin (Hb) at a higher level. The US Food and Drug Administration (FDA) announced revisions and warning to restrict ESA indications. This report describes the prevalence of anemia in cancer patients and its management given the recent confusion and uncertainties. Methods We retrospectively reviewed all consecutive adult cancer patients admitted to regular medical units between Jan and Dec, 2008. Patients admitted to Leukemia, Bone Marrow Transplantation and Intensive Care Units were excluded. Demographic features, reasons for admission, primary cancer diagnosis and disease stage were determined. All patients with Hb value < 12 g/dL at any time during admission were considered anemic. Treatment offered for anemia was also reviewed. Subsequent admissions for the same patients during the study period were also followed up. Results 959 patients (51% males, median age 55 years, range 18- 91) admitted 1862 times were included. Reasons for admission at time of enrollment included chemotherapy (23%), infections including neutropenic fever (20%), palliative and supportive care (15%). Other reasons included pulmonary, neurological, renal and electrolyte imbalances. Primary cancer diagnosis included: Gastrointestinal (21%), Breast (16%), Lymphoma and Multiple Myeloma (16%), and Lung (11%). At time of enrollment, 55% of patients had advanced stage disease. Anemia at any time during admission was detected in 755 (78.7%) patients. Mean Hb value for anemic patients was 9.51 g/dL (range 3.5-11.9, median 9.6). Severe anemia (Hb < 8) was documented in 16.7%, moderate anemia (Hb 8-10) in 41.9% and mild anemia (Hb > 10) in 41.5% of the patients. Majority (69%) of the patients were not offered any treatment for their anemia. Among the total group, blood transfusion was offered for 25%, supplements (including iron, folate and or vitamin B12) for 3.3%. ESA were offered for only 1.1%. Few patients (2.1%) had combined treatment. Mean Hb value at which treatment was started was 8 g/dL, while mean Hb for the patients who were not treated was 10.2 g/dL. Most of the patients (94%) with severe anemia, 32% with the moderate, and 5% of the patients with mild anemia were treated as shown in the table. Conclusions Anemia among adult cancer patients admitted to regular medical units is quiet common. Given the recent FDA warning and the many confusing studies, the prevalence of anemia in cancer patients was found to be high; many of such patients were not offered any treatment. The threshold to start treatment was highly dependent on its severity. Blood transfusion was the most common treatment method. Quality improvement projects should be implemented to better recognize and treat anemia in cancer patients. Disclosures No relevant conflicts of interest to declare.

Effect of a new algorithm on blood transfusion during postpartum hemorrhage (PPH)

2013 ◽  
Vol 30 ◽  
pp. 175-175
Author(s):  
C. Chapellas ◽  
J. Cros ◽  
S. Ponsonnard ◽  
B. Youssef ◽  
P. Sengès ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage

scholarly journals The Value of Body Surface Area Used in Postpartum Hemorrhage Define Postpartum Hemorrhage 

2021 ◽  
Author(s):  
Xianyan Lu ◽  
Tao Liu ◽  
Yan Zhou ◽  
Lili Qiu ◽  
Yimin Dai
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Blood Volume ◽  
Body Surface ◽  
Postpartum Hemorrhage ◽  
Total Blood Volume ◽  
Total Blood ◽  
Specificity And Sensitivity

Abstract Background: Blood loss as a percentage of total blood volume for redefining PPH may be more appropriate compared to the 500ml cutoff for every pregnant woman. This study is to investigate the value of body surface area in redefining PPH.Methods: In our prospective clinical observational study, we calculated the total blood volume using body surface area and measured blood loss at delivery using gravimetric and volumetric methods for all pregnant women included in our cohort (n=1715). For the five different body surface area groups, we determined different percentages of blood loss in total blood volume among 1201 participants. Furthermore, we compared the prediction values in blood transfusion based on the quantification of bleeding or proportion of blood loss in total blood volume at different quintiles among 514 severe PPH cases. Results: The median total blood volume and body surface area were 4639ml and 1.73 m2, respectively. The median total blood volume increased with increasing body surface area, and the different proportions of total blood volume increased accordingly. The median blood loss was 380ml and represented 8.28% of total blood volume. The median measured 24h blood loss across quintile 1 to 5 was 363ml, 360ml, 390ml, 380ml, 440ml, respectively. Using the definition with blood loss of 500 ml and 13% percentage of total blood volume, the incidence of PPH was 30% and 19%. However, the changes of the circulatory system secondary to obstetric hemorrhage was not significantly different at each quintile. Additionally, use of blood loss or the percentage of blood loss in total blood volume has high specificity and sensitivity as the indicators to predict blood transfusion.Conclusions: Our results suggest that blood loss exceeds 13% of total blood volume as a definition of postpartum hemorrhage. Blood loss above 30% of total blood volume may be recommended for blood transfusion.

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