Uso de sangre en obstetricia y ginecología en el mundo en desarrollo
The use of blood in obstetrics and gynecology in the developing world.
Schantz-Dunn J, M N.
Brigham and Women's Hospital, Division of Global Obstetrics and Gynecology, Harvard Medical School Boston, MA.
Rev Obstet Gynecol. 2011 Summer;4(2):86-91.
Abstract
Access to safe blood is critical in comprehensive emergency obstetric care and for reducing maternal mortality. Many countries have inadequate blood supplies, and this disproportionately affects women and children in need of life-saving blood transfusions. Although preventative measures aimed at reducing postpartum hemorrhage by treating underlying anemia and infectious diseases are critical, they are insufficient for obstetric hemorrhage. In the developing world, efforts should focus on alternative means of providing safe blood in cases of hemorrhage, with particular focus on rapid testing, donation of warm whole blood, and autologous blood transfusion.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218550/pdf/RIOG004002
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Tratamiento de la hemorragia postpartum intratable en un hospital de tercer nivel. Experiencia de 5 años
Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience.
Cengiz H, Yasar L, Ekin M, Kaya C, Karakas S.
Department of Gynecology and Obstetrics, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.
Niger Med J. 2012 Apr;53(2):85-8. doi: 10.4103/0300-1652.103548.
Abstract
BACKGROUND: The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied. MATERIALS AND METHODS: This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records. RESULTS: In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27-39 years). The mean gestational age was 38.3±1.3 weeks (range 37-41 weeks). Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50-130 minutes) and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy. CONCLUSIONS: In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530254/
Sangre autóloga en obstetricia. ¿Hacia donde vamos?
Autologous blood in obstetrics: where are we going now?
Liumbruno GM, Liumbruno C, Rafanelli D.
Immunohaematology and Transfusion Medicine Unit, San Giovanni Calibita Fatebenefratelli Hospital, AFAR, Rome.
Blood Transfus. 2012 Apr;10(2):125-47. doi: 10.2450/2011.0010-11. Epub 2011 Oct 25.
Abstract
In developed countries, pregnancy-related transfusion accounts for about 6 percent of red blood cell (RBC) units transfused. This means that, for example, in the UK as a whole, approximately 70,000 units of RBC are transfused to obstetric patients each year2. The pattern of blood usage is very different in countries in which diagnostic and treatment options are more limited, with 37 percent of transfusions being given to women with obstetric emergencies
http://www.bloodtransfusion.it/scarica.aspx?tipo=A&id=002322&riv=73
Atentamente
Dr. Benito Cortes-Blanco
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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