title: Maternal and Perinatal Outcome of Life Threatening Obstetrical Complications Requiring Multiple Transfusions.
abstract: BACKGROUND
  Obstetrical haemorrhage is the direct cause of maternal mortality, which can be prevented by timely recognition followed by quick and adequate treatment.
  
  
  OBJECTIVE
  To evaluate maternal and perinatal outcome of life threatening obstetric complications requiring multiple transfusions.
  
  
  METHODS
  It is an observational study conducted on 112 antenatal and postnatal women admitted in a tertiary level hospital, requiring blood and blood products transfusion of >1.5 liters in 24 hours, over a period of 15 months (Aug 2011 to Oct 2012). The demographic and obstetrical profile, amount transfused, mode of delivery, duration of hospital stay, maternal and neonatal morbidity and mortality was evaluated.
  
  
  METHODS
  Statistical analysis of the data was performed using chi-squared test.
  
  
  RESULTS
  There were 95 women who presented in antepartum period and 17 in the postpartum. Multigravidas comprised of 70 women, 81 had unsupervised pregnancies and 33 women presented in shock. At admission, 76 peripartum women had severe anaemia and 62 had coagulopathy. Obstetrical hysterectomy was done for 33 women and total 17 women expired. Haemorrhage was the most common indication for transfusion. The mean blood transfusion and volume replacement in 24 hours was 4.2 units & 2.25 liters respectively. The mean hospital stay was 10-15 days. Intra-uterine death at the time of admission was present in 40 women and 72 had live births. After birth, 21 babies required neonatal intensive care, of which 6 expired.
  
  
  CONCLUSIONS
  Antenatal care is important to prevent complications though pregnancy is always unpredictable. Patients' condition at admission is single most important factor often influencing the maternal and perinatal outcome.
authors.affiliation: Assistant Professor, Department of Obstetrics and Gynaecology, Dr BSA Medical College & Hospital , Rohini, Delhi, India .
authors.forename: Ritu
authors.initials: R
authors.lastname: Khatuja
authors.affiliation: Consultant Infertility and High-Risk pregnancy, 89 North Speciality Clinic , Kamla Nagar, Delhi, India .
authors.forename: Geetika
authors.initials: G
authors.lastname: Jain
authors.affiliation: Director Head of Department, Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital , Delhi, India .
authors.forename: Gita
authors.initials: G
authors.lastname: Radhakrishnan
authors.affiliation: Specialist, Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital , Delhi, India .
authors.forename: A G
authors.initials: AG
authors.lastname: Radhika
authors.affiliation: Scientist C, National Institute of Medical Statistics (ICMR) Ansari Nagar, New Delhi, India .
authors.forename: Atul
authors.initials: A
authors.lastname: Juneja
authors.affiliation: Head of Blood Bank and Director of Regional Blood, Department of Transfusion Medicine, Centre, UCMS and Guru Teg Bahadur Hospital , Delhi, India .
authors.forename: Bharat
authors.initials: B
authors.lastname: Singh
keywords: Blood products; Obstetrical outcome; Transfusion