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Abstrakt

Factors Affecting Blood and Blood Product Replacement in Patients Admitted to the Intensive Care Unit due to Postpartum Hemorrhage

Osman Uzundere* and Cem Kivilcim Kacar

Objective: In this study, we aimed to determine the factors affecting the blood and blood product replacement by examining patients who were admitted to the intensive care unit due to postpartum hemorrhage.

Material and methods: The present study was conducted by retrospective analysis of 374 patients’ records who were admitted to the intensive care unit due to postpartum hemorrhage. Patients were divided into two groups: those who were not transfused with blood and blood product (Group 1) and those who were transfused (Group 2). The groups were compared in terms of age, blood type, comorbidities, gravidity, parity, gestational age, type of delivery, the status of the fetus, hemoglobin levels, hematocrit levels, platelet levels, and duration of stay in the intensive care unit.

Findings: There was no need for replacement in 169 patients (Group 1) while 205 patients received a replacement (Group 2). Patients’ hemoglobin and hematocrit levels in Group 2 were lower than those of Group 1 (p values, respectively: <0.001, <0.001). The mean duration of stay in the intensive care unit for the patients in Group 2 was found to be significantly higher than those in Group 1 (p<0.001). Patients who had comorbidity (p=0.009) and patients who developed postpartum hemorrhage after vaginal delivery (p<0.001) were found to receive more blood and blood product replacement. Patients who underwent caesarean delivery under general anesthesia received more blood and/or blood products replacement (p=0.017). Patients admitted to the intensive care unit due to placental abnormalities, placental abruption, and uterine rupture required more blood and/or blood products replacement (p=0.01).

Conclusion: Patients who had low hemoglobin and hematocrit levels, comorbid diseases (such as anemia), vaginal delivery, caesarean delivery under general anesthesia, placental abnormalities, placental abruption, and uterine rupture require more blood and blood product replacement.