Efficacy of transfusion with fresh-frozen plasma:red blood cell concentrate ratio of 1 or more for amniotic fluid embolism with coagulopathy: a case-control study

被引：16

作者：

Tanaka, Hiroaki ^{[1
]}

Katsuragi, Shinji ^{[2
]}

Osato, Kazuhiro ^{[1
]}

Hasegawa, Junichi ^{[3
]}

Nakata, Masahiko ^{[4
]}

Murakoshi, Takeshi ^{[5
]}

Yoshimatsu, Jun ^{[6
]}

Sekizawa, Akihiko ^{[3
]}

Kanayama, Naohiro ^{[7
]}

Ishiwata, Isamu ^{[8
]}

Ikeda, Tomoaki ^{[1
]}

机构：

[1] Mie Univ, Sch Med, Dept Obstet & Gynecol, 2-174 Edobashi, Tsu, Mie 5140001, Japan

[2] Sakakibara Heart Inst, Dept Obstet & Gynecol, Tokyo, Japan

[3] Showa Univ, Dept Obstet & Gynecol, Sch Med, Tokyo, Japan

[4] Toho Univ, Dept Obstet & Gynecol, Omori Med Ctr, Tokyo, Japan

[5] Seirei Hamamatsu Gen Hosp, Div Perinatol, Maternal & Perinatal Care Ctr, Shizuoka, Japan

[6] Natl Cerebral & Cardiovasc Ctr, Div Maternal Fetal Med & Gynecol, Osaka, Japan

[7] Hamamatsu Univ Sch Med, Dept Obstet & Gynecol, Shizuoka, Japan

[8] Ishiwata Obstet & Gynecol Hosp, Ibaraki, Japan

来源：

TRANSFUSION | 2016年 / 56卷 / 12期

关键词：

MAJOR OBSTETRIC HEMORRHAGE; MASSIVE TRANSFUSION; TRAUMA PATIENTS; MANAGEMENT; STRATEGIES; MORTALITY; PLATELET;

D O I：

10.1111/trf.13856

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUNDThe Japan Association of Obstetricians and Gynecologists (JAOG) recommends transfusion with a fresh-frozen plasma (FFP):red blood cell (RBC) ratio of 1 or more in postpartum hemorrhage. However, no global consensus exists concerning this, and little is known regarding the impact of FFP:RBC ratio on maternal mortality. This study evaluates the efficacy of transfusion with FFP:RBC ratio of 1 or more for amniotic fluid embolism (AFE) with coagulopathy. STUDY DESIGN AND METHODSThe Maternal Death Exploratory Committee, established by the JAOG, conducted this retrospective nationwide case-control study in Japan. Women with AFE and coagulopathy were included in the study and were stratified into survival and death groups. Obstetric variables and therapy methods (hysterectomy, uterine artery embolism, and transfusion with FFP:RBC ratio1) were compared between the survival and death groups. RESULTSA total of 54 women had AFE and coagulopathy (death group, n=22; survival group, n=32). Only nine (40.9%) women in the death group were transfused with FFP:RBC ratio of 1 or more, whereas 29 (90.6%) women in the survival group were transfused with FFP:RBC ratio of 1 or more. FFP:RBC ratio of 1 or more was found to be associated with better survival rate (adjusted odds ratio, 28.32; 95% confidence interval, 4.26-188.37). No difference was found in obstetric variables, hysterectomy, and uterine artery embolism between survival and death groups. CONCLUSIONTransfusion with FFP:RBC ratio of 1 or more is associated with higher survival rate in women with AFE with coagulopathy.

引用

页码：3042 / 3046

页数：5

共 16 条

[1] Transfusion and coagulation management in major obstetric hemorrhage [J].