Abstract

Blood transfusion in obstetric patients presents unique challenges due to physiological changes during pregnancy and the potential for massive hemorrhage, making understanding of transfusion practices and outcomes crucial for optimizing maternal care and reducing transfusion-related complications. This retrospective observational study aimed to analyze blood transfusion practices, indications, outcomes, and associated factors in obstetric patients at a tertiary care centre over a two-year period from January 2022 to December 2023. All obstetric patients who received blood transfusions during pregnancy, delivery, or postpartum period were included, with data collected on patient demographics, obstetric history, indications for transfusion, blood products used, pre and post-transfusion hemoglobin levels, complications, and maternal outcomes. Of 8,456 deliveries during the study period, 347 patients (4.1%) received blood transfusions with a mean age of 28.4 ± 5.2 years. Primary indications included postpartum hemorrhage (52.4%), antepartum hemorrhage (23.1%), and severe anemia (18.6%). Packed red blood cells were the most commonly transfused product (89.3%), followed by fresh frozen plasma (34.6%), with an average of 2.8 ± 1.6 units transfused per patient. Maternal mortality was 0.6% (2 cases), both associated with massive transfusion protocols, while post-transfusion hemoglobin levels showed significant improvement (p < 0.001). The study concluded that blood transfusion rates in obstetric patients remain significant, with postpartum hemorrhage being the leading indication, and standardized protocols and early intervention strategies can improve outcomes and reduce transfusion requirements.