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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
MARTINEZ-MARTINEZ, Crescencio et al. Transfusion-related acute lung injury in obstetric hemorrhage: prevalence and risk factors. Ginecol. obstet. Méx. [online]. 2021, vol.89, n.4, pp.318-324. Epub Feb 11, 2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v89i4.4932.
OBJECTIVE:
To determine the prevalence and risk factors of transfusion-associated lung injury in obstetric hemorrhage.
MATERIALS AND METHODS:
Retrospective and comparative case series study, carried out in the Obstetric Intensive Care Unit (OICU) at the Hospital Materno Infantil ISSEMyM from 2014 to 2018. Patients with history of obstetric haemorrhage and transfusion were included. To associate the risk factors and the development of transfusion related acute long injury, χ2, Fisher and Student's t tests were performed, considering a significant p value less than 0.05 and a CI95%.
RESULTS:
From a total of 511 records, the prevalence of obstetric hemorrhage was 28.37%. The mean age was 32.57 years, with an average bleeding of 2679 mL. The prevalence of transfusion related acute long injury in the study was 11.03%. A significant association was found between massive transfusion and the development of transfusion related acute long injury (p = 0.001, OR: 21,167;95%CI: 3,507 - 127,747), in addition to the association of transfusion related acute long injury with any type of blood component: erythrocyte concentrate (p = 0.004), fresh frozen plasma (p = 0.0001), platelet apheresis (p = 0.015) and cryoprecipitates (p = 0.002).
CONCLUSIONS:
There are very few documented reports of transfusion related acute long injury in pregnancy and puerperium with obstetric hemorrhage. In the present study, the prevalence of transfusion related acute long injury in patients with obstetric bleeding was 11.03%. and the main cause of obstetric hemorrhage was uterine atony (45.5%). Massive transfusion and the use of blood components had a significant association with the development of transfusion related acute long injury.
Keywords : Transfusion-related acute lung injury; TRALI; Obstetric Hemorrhage.