Academic Department of Obstetrics and Gynaecology, Imperial College London, London, UK.
Department of Obstetrics, Chelsea and Westminster Hospital, London, UK.
Int J Gynaecol Obstet. 2017 Dec;139(3):342-345. doi: 10.1002/ijgo.12309. Epub 2017 Sep 13.
To examine whether professional guidance promoting a policy of restrictive blood transfusion is being followed.
A retrospective analysis of post-delivery transfusion data from 17 maternity units in the UK (1988-2000) was undertaken. Additionally, an audit was performed of women receiving one or two units of red cells 6-24 hours after delivery at three centers in the UK and USA in 2013-2016.
Between 1988 and 2000, 4700 women received one or two transfusions: 303 (6.4%) received one unit and 4397 (93.6%) received two. Median estimated blood loss (EBL) was similar in both groups (600 mL [IQR 400-1000] vs 700 mL [IQR 400-1000], respectively; P=0.862]. Between 2013 and 2016, 41, 22, and 64 women received one or two units during transfusion at centers A, B, and C, respectively. Two units were transfused for 40 (97.6%) of the women in center A, 21 (95.5%) at center B, and 58 (90.6%) at center C. Median EBL was similar, irrespective of whether one or two units were given.
Current transfusion practice deviates from evidence-based guidelines. Either by default or longstanding tradition, more women receive two rather than one unit despite similar EBL.
考察是否遵循了促进限制性输血政策的专业指导。
对英国 17 家产科单位（1988-2000 年）产后输血数据进行回顾性分析。此外，对英国和美国的 3 个中心的 2013-2016 年产后 6-24 小时内接受 1 或 2 单位红细胞的妇女进行了审计。
1988 年至 2000 年期间，4700 名妇女接受了 1 或 2 次输血：303 名（6.4%）接受了 1 单位，4397 名（93.6%）接受了 2 单位。两组的中位估计失血量（EBL）相似（分别为 600ml[IQR 400-1000]和 700ml[IQR 400-1000]；P=0.862）。2013 年至 2016 年期间，A、B、C 中心在输血期间分别有 41、22、64 名妇女接受了 1 或 2 单位输血。A 中心有 40 名（97.6%）妇女输注 2 单位，B 中心有 21 名（95.5%），C 中心有 58 名（90.6%）。无论输注 1 单位还是 2 单位，EBL 中位数相似。
当前的输血实践偏离了循证指南。由于默认或长期传统，尽管 EBL 相似，但更多的妇女接受 2 单位而不是 1 单位。
