Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria.docVIP

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Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria.doc

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Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria

Akinolaetal.BMCPregnancyandChildbirth2010,10:57 /1471-2393/10/57 RESEARCH ARTICLE OpenAccess Evaluationofbloodreservationandusefor caesareansectionsinatertiarymaternityunitin southwesternNigeria OluwarotimiIAkinola*,AdetokunboOFabamwo,AdetokunboOTayo,KabiruARabiu,YussufAOshodi, ChiomaAOnyekwere Abstract Background:Haemorrhagefromobstetriccausesisthemostcommoncauseofmaternalmortalityinthe developingworld.Preventionofmortalityfromhaemorrhagewillnecessarilyinvolvepromptbloodtransfusions amongotherlifesavingmeasures.Therearehoweverlimitedstocksoffreshorstoredbloodinmanyhealthcare facilitiesinSubSaharanAfrica.Caesareansectionhasbeenidentifiedasacommonindicationforbloodtransfusion inobstetricspracticeanditsperformanceisoftendelayedbynonavailabilityofbloodinourcentre.Anevaluation ofbloodreservationanduseatcaesareansectionsinatertiarymaternityunitinLagos,southwesternNigeria shouldthereforeassistinformulatingthemostrationalbloodtransfusionpolicies. Methods:Caserecordsof327patientswhohadelectiveandemergencycaesariansectionsattheLagosState UniversityTeachingHospitalbetween1st Octoberand31st December2007werereviewed.Datapertainingtoage, parity,bookingstatus,typeandindicationforCaesareansection,pre-andpost-operativepackedcellvolume, bloodlossatsurgery,unitsofbloodreservedinthebloodbank,unit(s)ofbloodtransfusedanddurationof hospitalstaywasextractedandthedataanalysed. Results:Therewere1056deliveriesoutofwhich327(31%)werebyCaesareansection.Duringthestudyperiod,a totalof654unitsofbloodwerereservedinthebloodbankandsubsequentlymadeavailableintheatre.Outof thisnumber,only89(13.6%)weretransfusedto41patients.Amongstthosetransfused,twenty-six(54%)were bookedand31(75.6%)hadprimarycaesariansection.About81%ofthosetransfusedhademergencycaesarean section.Themostcommonindicationforsurgeryamongthosetransfusedwereplacentapraevia(9patientswith 21unitsofblood)andcephalo-pelvicdisproportion(8patientswith13units). Conclusion:Eventhoughalargenumberofunitsofbloodwasreservedandmadeavailableinthethe