Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 11 , ISSUE 6 ( November-December, 2019 ) > List of Articles

Original Article

Utilization of Blood and Appropriateness of Blood Transfusion in a Department of Obstetrics and Gynecology in Karachi

Sonia Husain, Rubina Izhar

Keywords : Blood utilization, Maximal surgical blood ordering schedule, Transfusion

Citation Information : Husain S, Izhar R. Utilization of Blood and Appropriateness of Blood Transfusion in a Department of Obstetrics and Gynecology in Karachi. J South Asian Feder Obs Gynae 2019; 11 (6):345-348.

DOI: 10.5005/jp-journals-10006-1725

License: CC BY-NC 4.0

Published Online: 25-12-2012

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: To assess the utilization of blood and appropriateness of blood transfusion using utilization indices in the gynecology and obstetrics department of a tertiary care center. Materials and methods: A retrospective observational study was carried out in Gynae unit 3 of Abbasi Shaheed Hospital from July 1, 2016, to December 31, 2016. For this study, case records of all women who had an elective or emergency procedure were compiled and reviewed. The blood utilization indices, cross-matched to the transfusion ratio (C/T ratio = number of units cross-matched/number of units transfused), transfusion probability (%T = number of patients transfused/number of patients cross-matched × 100), and transfusion index (TI = number of units transfused/number of patients cross-matched) were calculated for all. Results: A total of 598 patients underwent major elective and emergency surgical procedures in the department. These patients were requested to prepare 1,074 units of blood. From a total of 1,074 units cross-matched, 374 were transfused. Thus, only 34.8% of the cross-matched blood was utilized. Of the 598 patients for whom blood was cross-matched, only 279 (46.65%) patients were transfused. The overall blood transfusion indices of the requested blood, C/T ratio, %T, and TI, were 2.87, 46%, and 0.62. Conclusion: Our study showed underutilization of blood in terms of cross-matched to the transfusion ratio but the probability of transfusion and the transfusion index were appropriate. Clinical significance: Blood ordering practices need to be reviewed periodically in all units.

  1. Hall TC, Pattenden C, Hollobone C, et al. Blood transfusion policies in elective general surgery: how to optimise cross-match-totransfusion ratios. Transfus Med Hemother 2013;40(1):27–31. DOI: 10.1159/000345660.
  2. Vibhute M, Kamath SK, Shetty A. Blood utilization in elective general surgery cases: requirements, ordering and transfusion practices. J Postgrad Med 2000;46(1):13–17.
  3. Friedman BA, Oberman HA, Chadwick AR, et al. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion 1976;16(4):380–387. DOI: 10.1046/j.1537- 2995.1976.16476247063.x.
  4. Singh JK, Singh P. Routine pre-operative cross-match for elective colorectal resections: an appropriate use of resources? Surgeon 2011;9(1):8–12. DOI: 10.1016/j.surge.2010.06.008.
  5. Ma M, Eckert K, Ralley F, et al. A retrospective study evaluating single-unit red blood cell transfusions in reducing allogeneic blood exposure. Transfusion Med 2005;15(4):307–312. DOI: 10.1111/j.0958- 7578.2005.00592.x.
  6. Afzal S. A comparison of public and private hospital on rational use of blood in Islamabad. J Pak Med Assoc 2013;63(1):85–89.
  7. World Health Organization. Universal access to safe blood transfusion. Available from URL: UniversalAccesstoSafeBT.pdf.
  8. Boral LI, Henry JB. The type and screen: a safe alternative and supplement in selected surgical procedures. Transfusion 1977;17(2):163–168. DOI: 10.1046/j.1537-2995.1977.17277151923.x.
  9. Mead JH, Anthony CD, Sattler M. Hemotherapy in elective surgery: an incidence report, review of the literature, and alternatives for guideline appraisal. Am J Clin Pathol 1980;74(2):223–227. DOI: 10.1093/ ajcp/74.2.223.
  10. Olawumi HO, Bolaji BO. Blood utilization in elective surgical procedures in Ilorin. Trop J Health Sci 2006;13(1):15–17. DOI: 10.4314/ tjhc.v13i1.36702.
  11. Sowayan SA. Use of blood in elective surgery: an area of wasted hospital resource. Ann Saudi Med 1994;14(4):326–328. DOI: 10.5144/0256-4947.1994.326.
  12. Belayneh T, Messele G, Abdissa Z, et al. Blood requisition and utilization practice in surgical patients at University of Gondar Hospital, Northwest Ethiopia. J Blood Transfus 2013;2013:758910. DOI: 10.1155/2013/758910.
  13. Khan FA, Khan M, Ali A, et al. Estimation of blood loss during Caesarean section: an audit. J Pak Med Assoc 2006;56(12):572–575.
  14. Yazdi AP, Alipour M, Jahanbakhsh SS, et al. A survey of blood request versus blood utilization at a university hospital in Iran. Arch Bone Jt Surg 2016;4(1):75–79.
  15. Ibrahim SZ, Mamdouh HM, Ramadan AM. Blood utilization for elective surgeries at main university hospital in Alexandria, Egypt. J Am Sci 2011;7(6):683–689.
  16. Goundan A, Kalra JK, Raveendran A, et al. Descriptive study of blood transfusion practices in women undergoing cesarean delivery. J Obstet Gynaecol Res 2011;37(10):1277–1278. DOI: 10.1111/j.1447- 0756.2010.01511.x.
  17. Begic D, Mujicic E, Coric J, et al. The management of transfusion services, analysis and assessment. Mater Sociomed 2016;28(4): 274–277. DOI: 10.5455/msm.2016.28.274-277.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.