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Red Blood Cell Transfusion after Postpartum Hemorrhage: Clinical Variables Associated with Lack of Postpartum Hemorrhage Etiology Identification.

Francisco Javier Ruiz-LabartaRocío Aracil RodríguezAinoa Sáez PratLaura Pérez BurrelJuan Manuel Pina MorenoMercedes Sánchez RodríguezMaría Pilar Pintado RecarteNatalio Garcia-HonduvillaMiguel Ángel OrtegaJavier Anguita VelascoAna Pérez CorralCoral BravoJuan Antonio de Leon-Luis
Published in: Journal of clinical medicine (2023)
Postpartum hemorrhage (PPH) remains a significant obstetric emergency worldwide and a leading cause of maternal death. However, it is commonly underreported, which can represent a major concern for maternal morbidity and mortality. This retrospective case series study analyzed patients with red blood cell transfusion (RBCt) in the postpartum period over a four-year interval at a specific center. A total of 18,674 patients delivered between January 2018 and December 2021. Patients with postpartum RBCt were classified into two groups: those with identified PPH (i-PPH) and those without (non-i-PPH). Clinical variables, delivery details, blood loss data, and treatment information were collected. Statistical analysis involved a comparison of variables between the i-PPH and non-i-PPH groups. Univariate and multivariate analyses were performed, aiming to identify significant associations between the clinical variables and a lack of PPH identification. The incidence of RBCt was 1.26% (236 cases). Patients receiving RBCt had higher rates of cesarean delivery, twin pregnancy, labor induction, and previous cesarean section. Among patients with postpartum RBCt, 34.3% lacked an identified PPH. The rarity of postpartum RBCt contrasts with the increasing rates of PPH, highlighting the importance of diagnosing PPH and postpartum anemia. A strategy of systematic quantification of blood loss during delivery could help detect PPH and anemia before adverse consequences occur.
Keyphrases
  • red blood cell
  • chronic kidney disease
  • end stage renal disease
  • healthcare
  • cardiac surgery
  • emergency department
  • physical activity
  • risk factors
  • sickle cell disease
  • adverse drug
  • replacement therapy