Managementof critically ill obstetric patients admitted to the intensive care unitrequires a multi-disciplinary team’s input. Blood and blood component therapyplays a vital role in managing such patients in Sri Lanka where the bloodproducts such as activated Recombinant factor VII or fibrinogen concentrate arenot freely available. Although obstetric patients are young and healthy, maternal mortality ratefor the patients admitted to an intensive care unit (ICU) ranges from 5–20% indeveloped countries and 15–30% in developing nations.Patient blood management isone of the widely discussed topics of the day in the transfusion world. Thereare several international guidelines developed to educate on the indicationsand triggers of blood and blood components transfusion in order to provideefficient patient care. They guide the clinicians and the transfusionphysicians on making critical decisions on initiating transfusions in anindividual.Sri Lanka is identified asone of the countries with a low maternal mortality rate when compared to theother South Asian countries (Sri Lanka- 30 deaths/100,000 live births; India- 200 deaths/100,000live births; Pakistan- 240 deaths/100,000 live births and Bangladesh 260 deaths/100,000live births- 2015).
Most literature available inSri Lanka focuses on major obstetric haemorrhage and the transfusion managementand there is only limited information available on all the obstetric patientsadmitted to the intensive care unit and their transfusion management. Point of care testing methodsare available in the tertiary obstetric centres, and international guidelinesare followed with a few adaptations according the resources available in SriLanka. De Soysa Maternity Hospital remains one of the major tertiary obstetriccentres in the country. Apart from the patients around Colombo, there arepatients who get transferred from the peripheries of the island for furtherspecialist management. The data obtained from this center could be invaluable. While we progress towards reducing unnecessary transfusions and relatedcomplications, and working on preventing the conditions leading to blood andcomponents transfusion, a timelyanalysis on the transfusion management, the triggers considered while makingthe decision of transfusion, patient blood management as well as the outcome ofthe patients admitted to the intensive care unit who have undergone atransfusion, will guide us to improve the quality of transfusion practice andpatient blood management in obstetric patients in Sri Lanka.