Restrictive strategy of transfusion therapy in the peripartum period: 616-035.1

Abstract

Summary. Introduction. The issue of peripartum bleeding and the validity of blood transfusions remains relevant. The patient blood management (PBМ) system has proven itself to be effective in reducing the volume of peripartum blood loss and the need for blood component transfusions. The implementation of PBМ principles allows to individualize approach to parturients and leads to significant cost savings
by reducing the frequency of transfusions and preventing expenditures on subsequent management of complications. Aim: to reduce the volume of blood loss and the number of blood component transfusions during the peripartum period. Materials and Methods. A prospectiveretrospective comparative reviewed the treatment outcomes of 584 patients with pathological pregnancy and peripartum bleeding were
examined. The study included two groups — group 1 (n=434) and group 2 (n=150) were comparable according to the main criteria (age, anthropometric data, concomitant pathology, gestational age, structure of diagnoses and types of delivery). In group 1 (prospective) the PBM principles were applied; donor components and drugs affecting blood coagulation properties were prescribed under control of rotational thromboelastometry (ROTEM). The patients from group 2 (retrospective) were treated in accordance with clinical guidelines, and the PBМ protocol was not followed. Results. In group 1, the patients with massive blood loss demonstrated a 42.5% decrease in blood loss, andthe proportion of patients with moderate and severe blood loss who received blood transfusions was lower compared with group 2 (donor plasma and erythrocytes decreased by 50%, platelet concentrate — by 66%, and cryoprecipitate — by 76%). The PBМ protocol allowed avoiding blood transfusions in group 1 parturients with peripartum blood loss of up to 1300 mL. Conclusion. The PBМ protocol in peripartum hemorrhage allows for a significant reduction in both the number of patients requiring blood transfusions and the amount of blood components used per person, which contributes to improved treatment outcomes.

For citation: Timokhova S.Yu., Ragimov A.A., Sinkov S.V., Grigoriev S.V., GolubtsovV.V., Ananich M.Yu. Restrictive strategy of transfusion therapy in the peripartum period. Tromboz, gemostaz i reologiya. 2025;(2):95–102. (In Russ.).

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