Blood Components Therapy as a Preventive Strategy for Coagulopathy in High-Risk Obstetric Patients in a Tertiary Centre in North India - An Interventional Study
BACKGROUND Obstetric practitioners routinely deal with antenatal patients who have high risk of developing established coagulopathy, which leads to a very high incidence of maternal morbidity and mortality. We wanted to assess the role of blood components in preventing disseminated intravascular coagulation (DIC) in highrisk patients and determine the amount of blood components required along with the rate of improvement in the DIC score, during treatment of high-risk obstetric patients of DIC and in patients with established DIC. METHODS This is an interventional study. 274 obstetric patients who were at high risk for developing DIC and / or with established DIC admitted during the 20 months study duration were included in the study. Patients were categorized in to three groups based on the DIC score according to ISTH scoring system in to non-overt and overt DIC groups. Those with DIC score < 5 were grouped as IA and IB randomly and those with DIC score > / = 5 were grouped as II. Software used was ANOVA using variance ratio F test for testing the significance between groups and chisquare test was used to find out the association between the groups or parameter. RESULTS Prophylactic transfusion of blood components showed faster rate of improvement than control group. Average consumption of blood components was more in patients of established coagulopathy as compared to non-overt group. CONCLUSIONS Transfusion of blood components can prevent overt DIC in high-risk patients. KEYWORDS DIC - Disseminated Intravascular Coagulation, PPH - Post Partum Haemorrhage, Coagulopathy, Component Therapy