scholarly journals Evaluation of Blood Transfusion Practices in Obstetrics and Gynecology in a Tertiary Hospital in Bangladesh

2016 ◽  
Vol 34 (1) ◽  
pp. 9-14
Author(s):  
Ferdousi Chowdhury ◽  
Sayeba Akhter ◽  
Aminul Islam ◽  
Junnu Rayen ◽  
Nayeema Begum ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Tertiary Hospital ◽  
Obstetrics And Gynecology ◽  
Junior Doctors ◽  
Transfusion Rate ◽  
Blood Products ◽  
College Hospital ◽  
Excessive Bleeding

Background: Blood transfusion is a life saving intervention in some obstetric and gynecological cases but is associated with risk of transfusion reaction and transmission of infection . Appropriate use of blood and blood products is of utmost importance for the safety of the patients. During the evaluation of an ongoing study on PPH,it appears that rate of blood transfusion is unexpectedly high in this centre, which raised the inquisitiveness in evaluating the rate and rationality of blood transfusion in present practice.Objective : To determine the incidence of blood transfusion in admitted and operated cases and is also to evaluate the indication of transfusion among the study patients. Subject and Method: It was an observational descriptive study, conducted from 1st April 2012 to 30th June 2012 in department of obstetrics and gynecology of Ad-din Women Medical College Hospital , Dhaka . Total 256 cases were included for the study, who received blood and /or blood products during the study period.Results: Transfusion rate in total admitted patients was 9.23% . Most common indication for blood transfusion in obstetric patients was mild preoperative anaemia with or without excessive bleeding during cesarean section (63.92%) and second common cause was antenatal anaemia (24.05%). In gynecological cases abortion (45.91%) was the commonest indication for blood transfusion and next common conditions were total abdominal hysterectomy (20.40%),vaginal hysterectomy (7.14%), ectopic pregnancy and post coital tear (6.12%) and( 6.12%).Conclusion: In this study it was observed that, blood transfusion was not appropriate in all cases, specially in cases where single unit blood was transfused . So creation of awareness among the junior doctors, obstetricians, nurses – midwives is essential by developing regular education and training programme.J Bangladesh Coll Phys Surg 2016; 34(1): 9-14

scholarly journals Step towards Formulating a Maximum Surgical Blood Ordering Schedule in Obstetrics and Gynecology

2016 ◽  
Vol 4 (2) ◽  
pp. 99 ◽  
Author(s):  
Shreyashi Aryal ◽  
Deepak Shrestha ◽  
Brijbala Bharadwaj ◽  
Narinder Kaur
Keyword(s):  
Blood Transfusion ◽  
Cesarean Section ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Transfusion Rate ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Utilization Patterns ◽  
Blood Usage ◽  
Transfusion Ratio

Introduction: Blood transfusion is an essential part of perioperative care in surgeries in obstetrics and gynecology. A tendency of over ordering of blood imposes additional workload to the blood bank and extra cost to the laboratory and patients. Maximum surgical blood ordering schedule (MSBOS) is a guide which helps in the decision of ordering and transfusing blood which reduces blood wastage. This study was done with the aim of evaluating the blood ordering and utilization patterns in obstetric and gynecologic surgeries and formulation of MSBOS for these procedures for the institute.   Methods: This is a cross-sectional, hospital based study conducted for the duration of three months. All patients undergoing major and minor surgeries at the department were included. Crossmatch to transfusion ratio (C/T), transfusion probability (%T), transfusion index (TI) and MSBOS were calculated for each procedure.   Results: Total 309 surgeries were performed in the department during the study period of three months. Most common surgery was emergency cesarean section (n=164, 53.1%) followed by abdominal hysterectomy (n=43, 13.9%). Utilization of crossmatched blood was 22.51%. Overall transfusion rate for all surgeries was 3.88%. Overall C/T ratio, %T, and TI were 4.44, 9.83 and 0.27 respectively which elicited indiscriminate ordering of blood.   Conclusion: Over ordering and under utilization of blood were seen in this audit. Blood ordering patterns need to change in order to minimize over ordering of blood which may prevent abuse of the system. MSBOS maybe an useful tool in this institute as it allows optimum blood usage for surgeries.

scholarly journals When A Life Saving Procedure Becomes Life Threatening

1970 ◽  
Vol 19 (2) ◽  
pp. 154-157
Author(s):  
MG Morshed ◽  
M Zahiruddin ◽  
S Tarunnum ◽  
S Sarker ◽  
AKMA Islam
Keyword(s):  
Blood Transfusion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
College Hospital ◽  
Renal Failure Patient ◽  
Medical College ◽  
Life Saving ◽  
Life Threatening ◽  
Blood Grouping

Most of the hospitalized patients are anaemic to some degree in our country and sometimes need blood transfusion. Complications of blood transfusion are rare but can be life-threatening. Since 2005, it has been a legal requirement that all serious adverse reactions attributable to the safety or quality of blood transfusion are reported. Most reported complications are because of transfusion of mismatched blood products and are avoidable with proper vigilance. A 45 year old female who underwent salpingo-oophorectomy with total abdominal hysterectomy for torsion of ovarian cyst and was transfused one unit of blood peroperatively. Blood grouping was accidentally incorrect and cross matching was not done. This mismatched blood transfusion resulted in acute renal failure. Patient was referred from the private hospital to Dhaka Medical College Hospital, Dhaka and was managed by forced alkaline diuresis and later, haemodialysis. Key words: Mismatched blood transfusion; haemolytic transfusion reactionDOI: 10.3329/jdmc.v19i2.7089J Dhaka Med Coll. 2010; 19(2) : 154-157

scholarly journals HISTOMORPHOLOGICAL SPECTRUM OF LESIONS OF HYSTERECTOMY SPECIMENS IN GCS MEDICAL COLLEGE, HOSPITALAND RESEARCH CENTER, AHMEDABAD : A STUDY OF 100 CASES

2020 ◽  
pp. 80-82
Author(s):  
Shweta Shah ◽  
S.K. Suri ◽  
Ami Shah
Keyword(s):  
Retrospective Study ◽  
Age Groups ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Medical College Hospital ◽  
Research Centre ◽  
Age Group ◽  
Gynaecological Surgery ◽  
College Hospital ◽  
Medical College

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

scholarly journals EFFECTS OF IDENTIFYING TRANSFUSIONAL INCIDENTS BY ACTIVE SEARCHING AT A TERTIARY HOSPITAL

2020 ◽  
Vol 11 (1) ◽  
pp. 10-22
Author(s):  
Henrique de Paula Bedaque ◽  
Rodolfo Daniel de Almeida Soares ◽  
Carolina Lemos de Brito ◽  
Gabriela Lia de Aquino Revoredo
Keyword(s):  
Blood Transfusion ◽  
Average Rate ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Blood Transfusions ◽  
Blood Components ◽  
Blood Products ◽  
Chi Square ◽  
Sentinel Network ◽  
Active Searching

Objective: The present study aims to analyze implementation consequences on active search for incidents related to blood transfusion at Onofre Lopes University Hospital (HUOL) and establish a blood transfusion profile in this facility. Methods: Blood transfusion and TIs registered on Hemotherapy Core at HUOL were counted through SPSS 20, comparing IT/1000 blood transfusion averages between 2012 and 2014. T Test of Student was used to compare data and chi-square (X²) and relative risk calculation to associate the use of blood components and risk to develop TI. Results: An increase of TI numbers at HUOL was shown by active searching and its equivalence to reference French and Brazilian services, liked to ANVISA sentinel network. Thus, there was a change in the average rate from 1.86 TI/1000 blood transfusions in 2012 to 5.36 TI/1000 blood transfusions in 2013 and 5.86 TI/1000 in 2014 (p = 0.001). It was also observed that the red blood cell concentrate is the fraction with the highest risk of occurrence of TIs (p = 0.003) and the greatest chance of causing any type of TI in relation to the other blood products, RR = 1.848 (95% CI; 1.042 - 3.266). It was also seen that the infusion of platelet concentrate is related to the allergic reaction (p <0.01), and greater risk compared to other blood components, RR = 2.746 (95% CI; 1.477 - 5.107). Conclusion: This study demonstrates active Hemovigilance importance on Tis subnotifications decrease.

scholarly journals Evaluation of total abdominal hysterectomy over the decade in Holy Family Red Crescent Medical College Hospital - A retrospective observational study

2016 ◽  
Vol 44 (2) ◽  
pp. 87-91
Author(s):  
Rumana Nazneen ◽  
Fahmida Monir ◽  
Salma Yeasmin ◽  
Sharmin Akhter ◽  
Lipy Bakshi ◽  
...  
Keyword(s):  
Observational Study ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Retrospective Observational Study ◽  
College Hospital ◽  
Common Indication ◽  
Medical College ◽  
Life Threatening ◽  
Post Menopausal

Hysterectomy is the commonest major surgical procedure in Gynaecology & usually performed to improve quality of life rather than to cure life-threatening conditions. The rates differ between countries depending on differences in morbidity, health economical aspects, traditions and attitudes. This retrospective observational study was carried out from 2001-2010 & included all cases of abdominal hysterectomy done for benign and non emergency conditions in the department of Obstetrics & Gynaecology, Holy Family Red Crescent Medical College and Hospital, Dhaka with the intention to assess the proportion and the indications of total abdominal hysterectomy over a 10-year period. Percentage of the total abdominal hysterectomy remained between 50-70% of the total major operations over the decade. Fibroid was found to be the most common indication among the admitted patients (around 36%) with highest percetage in 2006 and 2007 (43% and 46% respectively). Next important indication was dysfunctional uterine bleeding (20%) followed by pelvic inflammatory disease (13%), ovarian mass (5%), endometriosis & adenomyosis (4%) and post menopausal bleeding (2%). The majority of hysterectomies were abdominal and the most common indication was uterine fibroids. The overall rate for hysterectomy remained reasonably stable.Bangladesh Med J. 2015 May; 44 (2): 87-91

Evaluation of Erythropoietin Stimulating Agents (ESA) and Their Effect on Blood Optimization for Cardiac Surgery

2020 ◽  
pp. 089719002096927
Author(s):  
Kristina S. Gill ◽  
Abigail D. Antigua ◽  
A. Kacee Barnett ◽  
Aubrey J. Hall ◽  
Charles T. Klodell
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Retrospective Cohort ◽  
Blood Transfusions ◽  
Transfusion Rate ◽  
Blood Products ◽  
Single Center ◽  
Drug Reactions ◽  
Significant Difference ◽  
Erythropoietin Stimulating Agents

Background: Cardiovascular surgeries increase the risk of receiving blood transfusions. Erythropoietin stimulating agents (ESAs) have been used to decrease the transfusion rate. The objective of this study was to evaluate the administration of blood products post-cardiothoracic surgery after receiving ESAs. Methods: This is a single-center, retrospective cohort study. Results: Between May 2017 to May 2018, 52 adult patients underwent cardiac surgery and received ESAs pre-operatively and/or post-operatively. A total of 35 patients were included in the study and 21 (60%) patients did not require a blood transfusion while 14 (40%) patients required a blood transfusion ( p = 0.597). The change in hemoglobin (Hgb = 0.773 g/dL, 1.7 g/dL; p = 0.002) and hematocrit (Hct = 2.31%, 4.3%; p = 0.04) was significantly different in patients who received ESAs alone versus ESAs with blood transfusion. Adverse drug reactions showed no significant difference between groups. Conclusions: In patients undergoing cardiac surgery, ESAs did not significantly reduce the need for blood transfusion. Future and larger studies are necessary to evaluate the effect of ESAs on blood transfusion.

A Low-Fidelity Total Abdominal Hysterectomy Teaching Model for Obstetrics and Gynecology Residents

2012 ◽  
Vol 7 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Alfred Hong ◽  
Patrick M. Mullin ◽  
Laila Al-Marayati ◽  
Sarah E. Peyre ◽  
Laila Muderspach ◽  
...  
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Teaching Model

scholarly journals A Case Report of High-Grade Endometrial Stromal Sarcoma: A Rare Cause of Abnormal Uterine Bleeding in a Young Woman

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nuntasiri Eamudomkarn ◽  
Yuwadee Itarat ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool
Keyword(s):  
Young Women ◽  
Endometrial Stromal Sarcoma ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Cavity ◽  
Rapid Progression ◽  
High Grade ◽  
Excessive Bleeding ◽  
Stromal Sarcoma

High-grade endometrial stromal sarcoma (HG-ESS) is a rare clinical entity, particularly among young women, and only few cases have been reported in the literature. Herein, we describe the case of a 21-year-old woman who presented with a four-month history of excessive bleeding per vagina. Endometrial curettage and cervical biopsy revealed a malignant round cell tumor suggestive of metastatic sarcoma of uterine origin. Computed tomography of the abdominopelvic region showed an enlarged uterus with diffused thickening throughout the entire endometrial cavity. Intraabdominal lymphadenopathy and ascites in the pelvic cavity were noted. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, resections of the enlarged pelvic nodes, omentectomy, and biopsy of the peritoneal nodules in the cul-de-sac. Histological examination revealed a tumor with a permeative growth pattern composed of uniformly high-grade round cells with brisk mitotic activity and extensive lymphovascular space invasion. Sections of the pelvic lymph nodes on both sides and the peritoneal nodule revealed multiple metastatic foci. Immunohistochemical studies showed positive diffuse staining for vimentin, CD 10, and cyclin D1. The pathological diagnosis was HG-ESS stage IIIC. The patient experienced rapid progression of the disease while receiving adjuvant treatment and succumbed eight months after the operation. HG-ESS is a rare cause of AUB in adolescents and young women but should be considered in the differential diagnosis.

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