Hematologic problems in pregnancy V. Obstetric transfusion therapy.

Abstract

A study of 37,186 admissions, from 1970 through 1974, to a large southern charity hospital obstetrics service revealed a striking 63 per cent reduction in number of patients receiving blood transfusions. Analysis showed no change in patient population, bleeding disorders, toxemia, incidence of obstetric hemorrhage, serious febrile morbidity, or incidence of antepartum anemia. In the study period cesarean section rate increased 77 per cent and anemia at delivery markedly decreased. Transfusions associated with spontaneous abortion decreased by 70 per cent, and after the third study year no patient undergoing legal abortion received blood. The study demonstrated improvement in specific hematinic therapy of antepartum anemia and avoidance of transfusion therapy in the presence of uncharacterized antepartum or puerperal anemia. Despite the remarkable decrease in blood transfusions, obstetric outcome (including perinatal mortality rate, maternal mortality rate, and serious febrile morbidity) did not suffer but, indeed, improved.