ความเหมาะสมในการเตรียมเลือดสำหรับการผ่าตัดคลอดทางหน้าท้อง โรงพยาบาลอุทัยธานี

Jongrak  Khanwilai

Authors

Jongrak Khanwilai Uthaithani Hospital

Keywords:

preoperative blood preparation, caesarean section, blood utilization indices

Abstract

Background: Preoperative over-ordering of blood may consume blood bank resources and money and increase the workload of blood bank personnel. This study aimed to evaluate the appropriateness of preoperative blood ordering for caesarean section in Uthaithani Hospital and the factors that affected intraoperative and within 24 hours postoperative blood transfusion.

Materials and methods: A retrospective descriptive study was conducted, enrolling pregnant women who underwent caesarean section from 1st October 2022 to 30th September 2023 at Uthaithani Hospital. Three indices of blood utilization—crossmatch to transfusion ratio (C/T ratio), transfusion probability (%T), and transfusion index (Ti)—were analyzed.

Results: There were 621 pregnant women who underwent caesarean section. Type and screen preoperative blood preparation was ordered in 285 patients (45.9%), and crossmatch blood preparation was ordered in 336 patients (54.1%). The data showed 445 units of packed red cells were prepared, and only 48 were used for 33 patients. The crossmatch to transfusion ratio (C/T ratio), transfusion probability (%T), and transfusion index (Ti) were 9.3, 9.8, and 0.14, respectively. The variables found to be significantly associated with an increased risk of transfusion were preoperative anemia and placenta previa.

Conclusion: Preoperative blood ordering for caesarean section in Uthaithani Hospital was inappropriate. Therefore, preoperative blood preparation should be performed using the type and screen method. However, the risk of postpartum hemorrhage and the patient’s safety should be considered.

Keywords: preoperative blood preparation, caesarean section, blood utilization indices

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