Point of care testing methods
are available in the tertiary obstetric centres, and international guidelines
are followed with a few adaptations according the resources available in Sri
Lanka. A timely analysis on the transfusion management, the triggers considered
while making the decision of transfusion, patient blood management as well as
the outcome of the patients admitted to the intensive care unit who have undergone
a transfusion, will guide us to improve the quality of transfusion practice and
patient blood management in obstetric patients.
Sri Lanka is identified as
one of the countries with a low maternal mortality rate when compared to the
other South Asian countries (Sri Lanka- 30 deaths/100,000 live births; India- 200 deaths/100,000
live births; Pakistan- 240 deaths/100,000 live births and Bangladesh 260 deaths/100,000
live births- 2015).
De Soysa Maternity Hospital
remains one of the major tertiary obstetric centres in Sri Lanka. Apart from
the patients around Colombo, there are patients who get transferred from the
peripheries of the island for further specialist management.
Most literature available in
Sri Lanka focus on major obstetric haemorrhage and the transfusion management and
there is only limited information available on all the obstetric patients
admitted to the intensive care unit and their transfusion management.
of critically ill obstetric patients admitted to the intensive care unit
requires a multi-disciplinary team’s input. Blood and blood component therapy
plays a vital role in managing such patients in Sri Lanka where the blood
products such as activated Recombinant factor VII or fibrinogen concentrate are
not freely available. Although obstetric patients are young and healthy, maternal mortality rate
for the patients admitted to an intensive care unit (ICU) ranges from 5–20% in
developed countries and 15–30% in developing nations.