Evaluation of allogeneic hemotransfusions in the maternity ward of the Regional University Hospital of Northern Paraná

Abstract

The risks inherent in allogeneic transfusions are well known. Although they have decreased in the last few years, it seems unlikely that they will be completely eliminated. It is essential that each patient is properly examined so that an appropriate transfusion is recommended or its possible substitution for safer, more effective and more accessible alternatives. During the gestational period there is more exposure to anemic risks, such as physiological anemia and puerperal bleedings. These women are thus considered a group of interest for possible alternatives for the allogeneic blood use. The purpose of this study was to evaluate the main transfusions recommendations in the Maternity Ward of the Regional University Hospital of Northern Paraná (HURNP – UEL). Two hundred and six patients’ records were analyzed, out of a total of 6552 patients hospitalized in the Maternity Ward of HURNP, from May 1999 to July 2004, who had undergone 274 hemotransfusions. The main data gathered were: epidemiological information; Hb rates; transfusions recommendations; gynecological surgeries and complications. The average age was 27,5 (14 – 44) years old. The most common indications were: acute anemia (62%), coagulopaties (7%); chronic anemia (7 %), hypovolemic shock (6%) and others (9%). In 9% of the cases, no blood transfusions were mentioned. In these cases, the Hb average rate was 9.6 g/dl. The most used hemocomponents were: erythrocyte concentrate (82%), platelets (4%), plasma (11%), and cryoprecipitate (3%). The Hb average rate in the erythrocyte concentrate transfusion was 7,15 g/dl. In 5% of these cases, the hemocomponent was prescribed in rates equal to or greater than 10 g/dl. The obstetrical procedures included cesareans, tubal sterilizations, puerperal hysterectomies, uterine curettages, forceps and normal deliveries with or without episiotomies. It is concluded that the transfusions recommendations must not be based exclusively on Hb/Ht rates. Although blood transfusions in the Maternity Ward of HURNP are carried out under acceptable criteria, it is possible to improve its recommendation concerning anemia during the pregnancy-puerperal cycle, avoiding unnecessary blood transfusions.