Protokol Transfusi Masif pada Obstetrik
World population’s access to safe blood is limited. Only 30% of countries in the world have comprehensive transfusion services in their countries. Meanwhile, massive transfusion therapy has poor survival rate with mortality rate of about 45-67%. The patient’s age, duration and severity of shock, Disseminated Intravascular Coagulation (DIC), and the amount of blood transfused affect the final outcome. Coagulopathy has a high mortality rate within 4-6 days after hospitalization. Many obstetrics and gynecology patients have the potential to require blood transfusions. Cesarean section (SC) and hysterectomy are two of the surgical procedures that are frequent and potentially bleeding, requiring blood transfusion. Other conditions are postpartum hemorrhage, placenta previa, and ruptured ectopic pregnancy. Bleeding in the obstetric field is still a highest cause of maternal death in Indonesia.
Akses masyarakat dunia terhadap darah yang aman sangat terbatas. Hanya sekitar 30% negara-negara di dunia yang mempunyai pelayanan transfusi yang menyeluruh di negaranya. Sementara itu, transfusi masif mempunyai angka survival yang rendah dengan mortalitas sekitar 45-67%. Usia pasien, durasi dan beratnya syok, Disseminated Intravascular Coagulation (DIC), dan jumlah darah yang ditransfusikan mempengaruhi keluaran pasien tersebut. Koagulopati memiliki angka mortalitas tinggi dalam 4-6 hari paska perawatan rumah sakit. Pasien-pasien di bidang obstetrik dan ginekologi banyak yang berpotensi memerlukan transfusi darah. Seksio sesaria (SC) dan histerektomi adalah dua tindakan bedah obstetrik yang sering dan berpotensi perdarahan sehingga memerlukan transfusi darah. Kondisi lainnya adalah perdarahan postpartum, placenta previa, dan ruptur kehamilan ektopik. Perdarahan di bidang obstetrik masih merupakan penyebab kematian ibu yang tinggi di Indonesia.
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