Early Versus Late Blood Transfusion in Puerperal Septic Shock Patients with Anemia -a QuasiExperimental Controlled Trial

Abstract

Objective: To compare the outcome of early blood transfusion i.e. within 6hrs. (hours) of admission VS late blood transfusion (after 6 hrs.) in puerperal septic shock patients with anemia. Study design: A prospective quasiexperimental controlled trial in ICU(intensive care unit) of lady Willingdon hospital, a tertiary care hospital of Obstetrics and gynecology from Aug2013 to July 2016. Population: Patients admitted with septic shock and anemia during puerperium in ICU . Methods: 74 patients were included in the study by purposive sampling technique. Exclusion criteria were an irreversible shock, chronic lung, and heart disease or those requiring surgical intervention. Surviving sepsis campaign guidelines were followed for the management of these patients. Effect of blood transfusion on the recovery of these subjects was studied. The study group consisted of 43 patients in which blood was transfused within 6hrs. of admission. Control group had 31 patients in whom blood could not be transfused within this period. The demographic features and outcome of both groups were recorded and entered on spss20 statistical package. Results: The time of recovery from hypotension, tachycardia, pulmonary edema, ventilator and cardiac support was significantly shorter in the study group compared to the control. A lesser number of blood transfusions was required to treat anemia in the study group. Maternal mortality was less in the study group (23.25%) as compared to control group (48.39%) with an odds ratio of decrease in maternal mortality of 0.323(.119-.877). Conclusion: Early blood transfusion shortens the time of recovery and decreases maternal mortality and morbidity in puerperal septic shock patients with anemia.