PREDICTORS AND OUTCOMES OF BLOOD TRANSFUSION IN OBSTETRICS AND GYNECOLOGY AT A TERTIARY CARE CENTRE

Abstract

Blood transfusion is a critical component of care in obstetrics and gynecology, particularly in the management of obstetric hemorrhage, severe anemia, and gynecological bleeding disorders. However, transfusion practices vary widely due to differences in patient characteristics, clinical presentation, and underlying pathology. Understanding predictors and outcomes of transfusion in real-world settings is essential for optimizing patient blood management and transfusion stewardship.

Objectives: To evaluate predictors, indications, and immediate outcomes of blood transfusion among obstetric and gynecological patients at a tertiary care centre, and to compare transfusion practices between the two groups.

Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynecology at a tertiary care centre over seven months (March–September 2025). All obstetric and gynecological patients receiving at least one blood transfusion during hospital admission were included using universal sampling. Sociodemographic variables, clinical parameters, anemia severity, indications for transfusion, blood component usage, transfusion burden, and transfusion reactions were recorded. Data were analyzed using SPSS version 23. Categorical variables were compared using the chi-square or Fisher’s exact test, and a p-value <0.05 was considered statistically significant.

Results: A total of 145 patients were included, comprising 76 obstetric (52.4%) and 69 gynecological (47.6%) patients. Gynecological patients were significantly older than obstetric patients (p<0.001) and were more likely to present with severe or very severe anemia (65.2% vs 27.6%; p<0.001). Prior intake of hematinics was significantly higher among obstetric patients (52.6% vs 7.2%; p<0.001). Obstetric transfusions were predominantly for asymptomatic anemia and hemorrhagic obstetric conditions, whereas gynecological transfusions were mainly due to abnormal uterine bleeding, fibroids, and malignancies (p<0.001). ABO blood group distribution, transfusion burden (number of PRBC units), and transfusion reaction rates did not differ significantly between the two groups. Transfusion reactions were rare, occurring in only one patient.

Conclusion: Predictors of blood transfusion differ markedly between obstetric and gynecological patients, with anemia severity, age, and underlying pathology playing key roles. Despite differing indications, transfusion burden and safety outcomes were comparable. Strengthening patient blood management strategies, particularly early anemia correction in gynecological patients and protocol-based hemorrhage management in obstetrics, may further optimize transfusion practices and resource utilization.