Pattern of Blood Transfusion among Women Undergoing Caesarean Section in a Tertiary Health Care Centre

2021 ◽  
Vol 15 (9) ◽  
pp. 2858-2862
Author(s):  
Umme habiba ◽  
Kalsoom Essa Bhattani ◽  
Zubaida Khanum Wazir ◽  
Samina Sohail ◽  
Hina Ameer Chughtai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Placenta Praevia ◽  
Emergency Cesarean

Background: Cesarean section delivery causes major risk factors in terms of intraoperative performance and blood loss while blood transfusion is a promising factor in emergency care in case of blood unavailability. Women undergoing cesarean section routinely require blood cross-matching. Aim: The present study aimed to evaluate the pattern of blood transfusion among women who underwent c/section at the tertiary care center. Materials and Methods: This cross-sectional study was conducted on 745 pregnant women who underwent cesarean section at Obstetrics & Gynaecology department of Quaid-e-Azam International Hospital Islamabad and PAF hospital Masroor, Karachi for duration of six months from January 2021 to June 2021. The demographic details, incidence of cesarean section, blood transfusion indications and types were recorded. Antenatal intraoperative and pre-operative details were also noted. Complications regarding blood transfusion were analyzed using multivariable analysis and EPI-statistical software v 3.5.3. Results: Of the total 745 cesarean sections, the prevalence of blood transfusion was 10.1%. About 75 women transfused 216 units of blood with packed cells tailed by Fresh Frozen Plasma (FFP). The prevalence of emergency cesarean section was 61 (81.3%) while general anesthesia was utilized in 27 (44.3%) cases. Fetal distress and placenta praevia were the common indications of cesarean section. Placenta praevia Respiratory rate (RR) was 5.01 (p<0.001). Other obstetric complications and risk factors were anemia, antepartum hemorrhage, hypertension, and previous cesarean section. The cross-matched transfusion ratio was 9.93 while the transfusion index and probabilities were 0.078 and 10.1 respectively. Conclusion: Our study found a higher prevalence of blood transfusion risks among pregnant women who underwent cesarean section. It has been observed that the risk of blood transfusion increased with placenta previa, preoperative maternal anemia, placenta abruption, and second stage cesarean section. During the antenatal period, the need for blood transfusion might be reduced with an increased concentration of maternal hemoglobin. Keywords: Blood transfusion, Complications, Caesarean delivery, Transfusion index

scholarly journals Clinical analysis of maternal and fetal outcomes in COVID-19 pregnant women undergoing cesarean section in a tertiary care center in Hyderabad, India

2021 ◽  
Vol 10 (2) ◽  
pp. 733
Author(s):  
Prabha Agrawal ◽  
Rahul Agrawal ◽  
Ganshyam Jagathkar
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
Stable Condition ◽  
Clinical Analysis ◽  
Team Approach ◽  
Tertiary Care Center ◽  
Third Trimester ◽  
Emergency Cesarean

The outbreak of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate. A serious public health threat, it has caused a major impact on health care systems with a significantly high mortality and morbidity. Physiological changes and immuno-compromised state make pregnant women vulnerable during infectious disease outbreaks and hence need a more cautious approach. With this report we aim to share our experience regarding clinical characteristics, management and outcomes of 10 diagnosed COVID-19 pregnant women undergoing cesarean section at Medicover hospital, a tertiary-care center in Hyderabad, India between July to September 2020. All 10 pregnant women were referred in their third trimester with diagnosis of COVID-19. 2 out of 10 patients had severe COVID-19 and were managed in the ICU. All patients underwent emergency cesarean sections and none of the infants were infected with COVID-19. At discharge, all patients and the newborns were in a clinically stable condition. Effective management strategies incorporating integrated team approach, early cesarean section and low-threshold for mechanical ventilation has been shown to be associated with favorable outcomes for mothers diagnosed with COVID-19 and their infants. Also, the present data does not support any evidence of vertical transmission of SARS-CoV-2 virus in those manifesting during the third trimester of pregnancy.

scholarly journals Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

2015 ◽  
Vol 16 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Cuneyt Eftal Taner ◽  
Atalay Ekin ◽  
Ulas Solmaz ◽  
Cenk Gezer ◽  
Birgul Cetin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Care Center ◽  
Tertiary Care ◽  
High Volume ◽  
Tertiary Care Center

scholarly journals Incidence and risk factors for retinopathy of prematurity at a medical college hospital in rural Tamil Nadu, India

2020 ◽  
Vol 7 (11) ◽  
pp. 2119
Author(s):  
Sengodi Elumalai ◽  
Rajasekaran Kathavarayan ◽  
Venkatesh Govindasamy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Transfusion ◽  
Retinopathy Of Prematurity ◽  
Tamil Nadu ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
College Hospital

Background: The objective of the research was to evaluate the incidence of retinopathy of prematurity (ROP), association of prenatal and postnatal risk factors, pattern of ROP and treatment outcomes among infants admitted to neonatal intensive care unit (NICU) of tertiary care center located in Thiruvannamalai, Tamil Nadu.Methods: A retrospective study done in all infants admitted between April 2019 and March 2020 who met the criteria for ROP screening with gestational age (GA) less than or equal to 36 weeks or birth weight less than 2000 grams or with GA more than 36 weeks and birth weight more than 2000 gram with significant risk factors like intrauterine growth restriction, respiratory distress syndrome, sepsis, long term oxygen use, phototherapy, blood transfusion and maternal anemia. Treatment was offered to infants with stage 3 ROP and stage 2 in zone 2 with or without plus disease. Qualified infants were treated with argon laser photocoagulation within 72 hours of diagnosis. They were followed until the disease was successfully treated.Results: Out of total 3121 neonates, 717 neonates met the screening criteria. Incidence of ROP was found to be 33% (n=237). 46.4% (n=110) of ROP belongs to 32-36 weeks GA. 42.6% (n=101) of ROP belongs to 1500-2000 gm birth weight.Conclusions: Incidence of ROP is quite high in high risk neonates in our unit. Significant risk factors are long term oxygen use, blood transfusion and sepsis.

scholarly journals Frequency of Placenta Previa in Multigravida at Tertiary Care Hospital

2018 ◽  
Vol 25 ◽  
pp. 59-63
Author(s):  
Mst Rokeya Khatun ◽  
KS Nasrin Lina ◽  
S Gul Nahar
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Gestational Age ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Pelvic Surgery ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Current Frequency

Background: Placenta previa is a localization of placenta in the lower uterine segment, near or over the internal os. Multigravida is one of the risk factors of placenta previa. The aim of study is to look for current frequency of placenta previa in multigravida, so that further improvement in diagnosis and treatment modalities can be made in order to decrease the morbidity & mortality related to it in this group.Objective: To determine the frequency of various grades of placenta previa in multigravida at a tertiary care center.Methodology: This is a cross sectional study conducted from December 2014 to June 2015 at the department of Gynecology and Obstetrics, Rajshahi Medical College Hospital. A total of 208 patients enrolled in the study with non -probability purposive sampling technique. All pregnant women with singleton pregnancy of 25-35 years of age in their second or more pregnancy with gestational age ≥ 34 weeks were included. Exclusion criteria observed for patients with multifetal pregnancy, previous history of cesarean section, dilatation and curettage, cervical cone biopsy, myomectomy or any pelvic surgery. All pregnant women had trans-abdominal ultrasound. The presence or absence of placenta previa was reported by an experienced sonologist. The data was analyzed using SPSS version 12.Results: Among the total recruited patients, mean age of these multigravidas was 30.1±5.6 years. The mean parity of our population was 4.02±1.2. The gestational age noted was 38±1.4 weeks as mean.. The frequency of placenta previa was 13 (6.3%) and type IV was the most common type.Conclusion: It is concluded from this study that the frequency of placenta previa in patients of multigravida was 6.3% and apart from other risk factors, multigravidity is an independent risk factor for placenta previa.TAJ 2012; 25: 59-63

scholarly journals The bleeding mother and her baby: a study to determine the fetomaternal outcome in cases of placenta previa

2020 ◽  
Vol 9 (9) ◽  
pp. 3775
Author(s):  
Preeti Frank Lewis ◽  
Sana Tarannum Bijapur ◽  
Deepika Gurnani
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Artery Ligation ◽  
Uterine Artery Ligation

Background: Placenta previa is one of the major causes for obstetric hemorrhagic morbidity and mortality with increasing incidence in recent times. This study aims at determining risk factors, maternal and fetal outcome associated with placenta previa.Methods: This was an observational, retrospective study conducted at a tertiary care hospital in Mumbai from May 2017 to March 2020. A total of 102 women with placenta previa during the study period were included, their case records critically analyzed to identify risk factors, maternal outcome in relation with blood transfusion required, ICU admission, obstetric hysterectomy and fetal outcome pertaining to prematurity, asphyxia and mortality.Results: A total of 102 patients were analyzed. Placenta previa was more common in >26 years of age, multipara (64.7%), with previous history of caesarean sections (21.5%) and previous curettage (11.7%), 44.2% babies born were preterm, 4.4% stillbirths and 8.5% neonatal deaths. Maternal complications like antepartum hemorrhage was seen in 58.8% patients and postpartum hemorrhage in 33.3%, blood transfusion was required in only 18 patients post operatively, bladder rent was seen in 3 patients and there was no maternal mortality. 44 patients required uterine artery ligation, Ashok Anand stitch was taken in 37 patients, uterus compression sutures in 10, obstetric hysterectomy in 7 patients and internal iliac artery ligation in 2 patients.Conclusions: Early identification of women at risk, obstetric preparedness and simple techniques like uterine artery ligation, Ashok Anand stitch and uterine compression sutures can help in effectively reducing need for multiple blood transfusions and morbidity.

scholarly journals Incidence And Risk Factors Of Maternal And Fetal Outcomes Among Patients Of Placenta Previa With And Without Placenta Accreta

2018 ◽  
Vol 09 (01) ◽  
pp. 57-61
Author(s):  
Samina Naseem Khattak ◽  
Umbreen Akram ◽  
Erum Pervaiz ◽  
Maria Anayat ◽  
Tahir Ahmad Munir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Military Hospital ◽  
Fetal Outcomes ◽  
Maternal Risk ◽  
Neonatal Deaths ◽  
The Mean

Objective: The aim of the study was to evaluate maternal and fetal outcomes among patients of placenta previa (PP) with and without placenta accreta (PA). Methodology: All patients who underwent cesarean section for PP and PA were analyzed retrospectively at a tertiary care Combined Military Hospital Kharian, Pakistan, from February 2015 to March 2018. Maternal and neonatal data were obtained from medical records and the hospital database system. Results: PA was found in 37 patients from 111 patients of PP and 74 were without PA with the rate of approximately 2/1000 and 4/1000 respectively were included in the study. The mean age was 31.16±2.65 (range 22–37) years, mean gravidity of 3.69 ±1.40 (range 1 - 9), mean parity 2.57±1.01 (range 1–5), mean number of cesarean sections 2.10±0.66, (range 1-3) and a mean gestational age at the time of cesarean section was 35.65±2.46 (range 28–41) weeks. The maternal risk factors revealed marked differences between placenta previa with accreta and without accrete. The mean intraoperative blood loss in PA was 3,000ml, with a loss of 2,000ml occurring in 60%, and 3,000 ml in 21% of the PA cases. The mean pRBC transfusion was 4 units, while 17% received 6 units. Fetal growth restriction was not seen. A total of 12 neonates were admitted in NICU, with 03 neonatal deaths. There was no maternal death. Neonates born to women with placenta accreta had significantly lower birth weight, Apgar scores at 1 min and 12% required admission to NICU with 3 neonatal deaths. Conclusion: The advanced maternal age, past cesarean or uterine surgery, high parity as well as multiple gravidity were the risk factors for adverse fetal and maternal outcomes.

scholarly journals Peripartum hysterectomy at a tertiary center

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Monica Gurung ◽  
Gehanath Baral
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Bladder Injury ◽  
Abnormal Placentation ◽  
Peripartum Hysterectomy ◽  
Tertiary Center ◽  
Emergency Peripartum Hysterectomy ◽  
Ruptured Uterus

Aims: To find out the incidence, indications, complication of emergency peripartum hysterectomy in a tertiary care center. Methods: This was a retrospective study conducted over a period of 18 months from April 2017 to October 2018 at Paropakar Maternity and Women’s Hospital in Kathmandu. Data were obtained from the operation theater register and record section. Results: Out of 30917 deliveries in 18 months 18 had lifesaving emergency peripartum hysterectomy (0.58 per 1000 deliveries). The most common indication being morbidly adherent placenta/placenta previa (8; 44%) followed by ruptured uterus (5; 28%), uterine atony (4; 22%). The most common risk factor is attributed to previous cesarean section (11; 61%) followed by abnormal placentation (7; 39%). Most common morbidity was febrile morbidity followed by wound infection and bladder injury. Conclusion: Abnormal placentation and past cesarean section contributed to be the major indication of peripartum hysterectomy.

scholarly journals A retrospective analysis on placenta previa in a tertiary care center of Jharkhand

2021 ◽  
Vol 10 (9) ◽  
pp. 3389
Author(s):  
Tanu Sharma
Keyword(s):  
Risk Factors ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Adherent Placenta ◽  
History Of ◽  
Nicu Admission

Background: When the placenta is implanted partially or completely in the lower uterine segment, it is called placenta previa. Previa is a Latin word means going before. About one-third of APH belongs to placenta previa and now a day’s incidence is increasing in primigravida patients. The objective of this study was to analyze the incidence, risk factors, maternal morbidity, mortality and perinatal outcome in women with placenta previa in a tertiary care center of Jharkhand.Methods: Total 193 cases of placenta previa were studied between September 2018 to August 2019 in the department of obstetrics and gynecology, RIMS, Ranchi with respect to their age, parity, gestational age, clinical presentation, previous history of curettage/hysterotomy/caesarean, ICU admission, need for NICU admission, maternal morbidity and mortality and perinatal outcome.Results: In this study, 1.94% of the deliveries were complicated with placenta previa. 31.6% were above 30 years, 87% were multigravida, 122, i.e.; 62.7% were having history of curettage or previous caesarean or hysterotomy. 49.7% had prior caesarean deliveries, 21.5% had prior abortion with history of D and C. 49.2% had true placenta previa. 68.4% had preterm delivery. 11.9% patients presented in shock and maximum i.e.; 184 (95.3%) out of 193 presented with painless bleeding per vaginum and 9 cases with no complaints. Malpresentation seen in 16.6% cases and 8.3% had adherent placenta previa. There were 45.6% ICU admission and 54.9% NICU admission, 2.5% maternal mortality and 32.6% perinatal mortality.Conclusions: Advanced maternal age, multiparty, scarred uterus as in prior CS or D and C are independent risk factors for placenta previa. Also, it remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa and associated adherent placenta should encourage a careful evaluation, timely diagnosis and delivery to reduce associated maternal and perinatal complications.

scholarly journals PLACENTA PREVIA;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
IFAT BALOCH ◽  
Naseem Bajari ◽  
Sabrina Talpur ◽  
Saima Naz Shaikh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Tertiary Care ◽  
University Hospital ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Emergency Cesarean ◽  
Precise Diagnosis ◽  
Elective Cesarean

Objectives: To determine the maternal and fetal outcomes in patients presented with major degree of placenta previa at tertiary care Hospital. Study Design: Descriptive cases series study. Setting: Department of Gynaecology and Obstetrics of Liaquat University Hospital Hyderabad. Period: One year from March 2015 to February 2016. Subject and Methods: All patients with major degrees of placenta previa were included in study. Following delivery the examination of neonate was carried out thoroughly including congenital abnormalities, weight of baby and Apgar score. Babies and mothers were examined within postoperative wards till stitches removal and systematically examined for any postoperative complication. All the data was entered in the proforma. Results: Total 50 patients with major degrees of placenta previa were selected. Majority of the women 40% belonged to the age group of 30-35 years. Most of the women 92.0%, were symptomatic and presented with painless vaginal bleeding. Elective cesarean section was performed among 20% patients while 80% patients underwent emergency cesarean section. 70% patients delivered preterm and 30% delivered at term. 3(6%) fetals were still births and 1(2.0%) presented macerated still birth. 16% fetuses developed respiratory distress syndrome, 6% had intrauterine growth restriction and only one had congenital abnormality (spina bifida). Neonatal weight less than 2500-grams was among 90%. Perinatal mortality was 6(12.0%), and according to maternal outcome, mortality rate was low i.e. just 1 subjects passed away. Conclusion: Major degree of placenta previais a significant contributor of obstetric hemorrhage in 02nd and 03rd trimesterof pregnancy as well as it adversely correlates with feto-maternal outcomes. Instant moving the case of obstetric hemorrhage to hospitals, precise diagnosis, sufficient transfusion provision, intervention without delay can reduce the fetomaternal morbidity and mortality.

scholarly journals Labour analgesia and obstetric outcome in heart disease complicating pregnancy in tertiary care center

2020 ◽  
Vol 9 (3) ◽  
pp. 1234
Author(s):  
Subha Sivagami Sengodan ◽  
Dhivya Sharona
Keyword(s):  
Cardiovascular Disease ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Cardiovascular Events ◽  
Care Center ◽  
Tertiary Care ◽  
Labour Analgesia ◽  
Obstetric Outcome ◽  
The Impact

Background: One of the most severe pain experienced by a woman is during child birth. It is imperative to understand the pain transmission for providing labour analgesia. Hemodynamic status in labour fluctuates greatly during uterine contraction and true labour pains. Therefore, pregnant women with cardiovascular disease need epidural anaesthesia during labour depending upon the type of cardiovascular disease. Objective of this study was to assess the impact of labour analgesia and the obstetric outcome and cardiac events during labour.Methods: This is an observational study conducted in 46 pregnant women with cardiovascular disease during the period of January 2019 to December 2019 (12 months).Results: A total of 46 antenatal mother with cardiovascular disease was admitted in the department of obstetrics and gynecology over a period of one year out of which 25 patients who had epidural analgesia during labour and 21 patients who had no epidural analgesia during labour. Cardiovascular events significantly reduced in epidural group (25 patients) and there was no increase in cesarean section in epidural group.Conclusions: The data showed there was significant decrease in cardiovascular events related to arrhythmia hence decreased maternal morbidity and mortality. There was no associated increase in cesarean section rate but slight increase in instrumental vaginal delivery.

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