Effectiveness index of Routine Crossmatch for Elective Caesarean Section
Keywords:
Blood preparation, Blood typing, Elective caesarean section, Routine crossmatch, Transfusion utilization indicesAbstract
Background: Routine crossmatching blood preparation
for elective caesarean section causes expensive waste of
resources and increases work load of blood bank staffs.
Objectives: To evaluate appropriateness and cost of
routine crossmatching blood preparation for elective
caesarean section by transfusion utilization indices.
Methods: A retrospective descriptive study was conducted
enrolling in pregnant women who underwent elective
caesarean section in year 2018.
Results: From 3rd January to 28th December 2018, 1,185
pregnant women undergoing elective caesarean section
with preoperative routine crossmatch 1 unit of PRC in
each patient. Only 8 patients (8 units) were transfused.
Transfusion utilization indices; C/T ratio, %T and Ti were
148.13, 0.68% and 0.007 respectively. Cost for routine
crossmatch was 331,800 baht but only 2,240 baht was
utilized.
Conclusions: Routine crossmatching 1 unit of PRC per
case for elective caesarean section was inappropriate and
wasteful. Blood crossmatch should be replaced with type
and screen to optimized request and expenditure.
References
rates and pregnancy outcomes: the 2005 WHO global survey
on maternal and perinatal health in Latin America. Lancet
2006;367:1819-29.
2. Rouse DJ, MacPherson C, Landon M. Blood transfusion and
cesarean delivery. Obstet Gynecol 2006;108:891-7.
3. Ransom SB, Fundaro G, Dombrowski MP. Cost-Effectiveness
of routine blood type and screen testing for caesarean
section. J Reprod Med 1999;44:592-94.
4. Ness PM, Rosche ME, Barrasso C, Luff RD, Johnson JW Jr.
The efficacy of type and screen to reduce unnecessary cross
matches for obstetric patients. Am J Obstet Gynecol 1981;
140:661-4.
5. Imberti R, Preseqlio I, Trolta V, Filiselti P, Mapelli A. Blood
transfusion during cesarean section, A 12 year’s retrospectively
study. Acta Anaesthesiol Belg 1990;41:139-44.
6. Kamani AA, McMorland GH, Wadsworth LD. Utilization of
red blood cell transfusion in an obstetric setting. Am J Obstet
Gynecol 1988;159:1177-81.
7. Silverman JA, Barrett J, Callum JL. The appropriateness of
red blood cell transfusion in the peripartum patient. Obstet
Gynecol 2004;104:1000-4.
8. Cousins LM, Teplick FB, Poeltler DM. Pre-cesarean blood
bank orders: a safe and less expensive approach. Obstet
Gynecol 1996;87:912-6.
9. Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti
G. Recommendation for the transfusion of red blood cells.
Blood Transfus 2009;7:49-64.
10. Gombotz H, Rehak PH, Shander A, Hofmann A. Blood use
in elective surgery: the Austrian benchmark study. Transfusion
2007;47:1468-80.
11. Palmer T, Wahr JA, O’Reilly M, Greenfield MLVH. Reducing
unnecessary cross-matching: a patient-specific blood
ordering system is more accurate in predicting who will
receive a blood transfusion than the maximum blood ordering
system. Anesth Analg 2003;96:369-75.
12. Guidelines for implementation of a maximum surgical blood
order schedule. The British Committee for Standards in
Haematology Blood Transfusion Task Force. Clin Lab
Haematol 1990;12:321-7.
13. Sripunlom N, Ratchanon S, Ouitrakul S. Appropriateness of
routine crossmatch in elective caesarean section for low risk
postpartum hemorrhage pregnancies. Clinics Mother Child
Health 2018; 15. DOI: 10.4172/2090-7214.1000283
14. Zewdie K, Genetu A, Mekonnen Y, Worku T, Sahlu A, Gulilalt
D. Efficiency of blood utilization in elective surgical patients.
BMC Health Services Research 2019;19:804.
15. Karnjanarachata C, Lavanrattanakul P, Apinyachon W,
Pravitharangul T. Crossmatch to transfusion ratio of blood
and risk factors associated with blood transfusion in patients
undergoing elective hepatic resection: retrospective review.
Thai J Anesthesiol 2019;45:1-6.
16. Tiloklurs M, Klunklin G, Yimsabai J. Reduction the cost of
blood preparation for transfusion in surgical patients by type
and screen. Buddhachinaraj Med J 2007;24:48-52.
17. Trakulkasamsiri S. Cost reduction of crossmatching by Type
and screen protocol in Obstetrics patients at Queen Savang
Vadhana Memorial Hospital, Thai Red Cross Society. Bull
Chiang Mai Assoc Med Sci 2007;40:114-7.
18. Chanachaisuwan P. Blood Utilization in Elective Surgery at
Police General Hospital. J Hematol Transfus Med 2010;20:93-
104.
19. Litu D, Simajareuk S, Chau-in W, Boonsagcharoen P,
Vachirodom D. Pre-operative routine cross-match for elective
breast surgery: an appropriate use of resources. Srinagarind
Med J 2012;27(4):401-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
Copyright of all articles published in the Thai Journal of Anesthesiology is held by the Thai Journal of Anesthesiology, the Royal College of Anesthesiologists of Thailand. Submission of a manuscript constitutes the authors' agreement that, upon acceptance for publication, copyright of the work is transferred to the Journal. The content and any opinions expressed in published articles are the sole responsibility of the authors and do not necessarily reflect the views of the editorial board or the Royal College of Anesthesiologists of Thailand.
Licensing
All articles are published open access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). Under this license, anyone may copy and redistribute published articles in any medium or format for non-commercial purposes, provided that appropriate credit is given to the authors and to the Thai Journal of Anesthesiology as the original source of publication, a link to the license is included, and the material is not modified in any way. Requests for commercial use or for adaptation of published material should be directed to the editorial office.
Authors' Rights
Although copyright is held by the Journal, authors retain the right to reuse their own published material in their future scholarly works, theses and dissertations, teaching, and academic presentations, and to deposit the final published version (PDF) in institutional or subject repositories or on personal and institutional websites, without embargo, provided that the Thai Journal of Anesthesiology is clearly acknowledged as the original place of publication.
