Abstract Number: PB2566
Meeting: ISTH 2020 Congress
Background: Worldwide postpartum haemorrhage (PPH) remains the leading cause of maternal mortality (WHO, 2018). There are no universally accepted definitions of PPH, which vary according to the use of estimated blood loss, quantities of blood transfused or evaluation of decreases in haemoglobin.
Aims: To evaluate the prevalence of PPH and severe PPH, blood transfusion management and mortality in a Portuguese tertiary maternity.
Methods: All parturient who had requests for blood components from January 2015 to December 2019 were selected. We defined PPH when red blood cells units (RBCU) were transfused and severe PPH when the accumulated blood loss was >1000ml and/or transfusion of ≥3 RBCU.
Results: In a total of 16568 deliveries (3314/year), blood components were ordered for 608 women, mean age 32.4yr (range 16-46), with RBCU transfusion in 46% of them (PPH prevalence of 1.7%). 35 parturient received ≥ 3 RBCUs, with a severe PPH prevalence of 0.21%. Severe PPH was due mainly to uterine atony (51,4% of the cases). In severe PPH, 19 (54%) women were transfused with only RBCU, 14 with RBCU and fibrinogen; fresh frozen plasma and platelet units were transfused in 10 and 6 women, respectively. Tranexamic acid was administered to 12 women. Two women (0.012% parturient) were transfused with >10 RBCU (massive HPP) in addition to other blood components and were submitted to hysterectomy. There were no cases of death, while nine women were admitted to the ICU and 6 undergone hysterectomies.
Conclusions: We found a lower PPH prevalence in comparison to the worldwide prevalence described before. As expected, severe PPH was associated with uterine atony. The low prevalence and the absence of PPH associated deaths mirror the importance of an early diagnosis and management, in a multidisciplinary approach, according to the established institutional protocol.
To cite this abstract in AMA style:Ferreira S, Santos F, Ferreira A, Silva C, Cruz E, Leite F, Coutinho M, Buchner G, Amil M, Braga J, Morais S, Coutinho J. Five Years of Evaluation of Postpartum Haemorrhage in a Tertiary Portuguese Hospital [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/five-years-of-evaluation-of-postpartum-haemorrhage-in-a-tertiary-portuguese-hospital/. Accessed May 19, 2022.
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