Efficacy and safety of the triggers for blood transfusion in obstetric patients: systematic review of randomized clinical trials

Abstract

International rates of obstetric transfusions vary from 0.1 to 1.9% and have increased in recent years. Transfusion of blood products is associated with extremely severe maternal morbidity and at least 26% of deaths secondary to postpartum hemorrhage are due to absence of blood transfusion. The goal of transfusion is to increase patient survival while seeking the diagnosis and / or therapy to become effective. However, blood transfusion can never be made unnecessarily since leads to complex changes in the immune system, producing modulations of the immune system, becoming a risk factor for hospital infection or recurrence of cancer. In addition, there is no consensus on the appointment of a blood transfusion, as well as, what is the concentration of more effective and safe hemoglobin to decrease the likelihood of morbidity and mortality. As pregnancy is an aggravating situation to the clinical picture of patients and may trigger complications to them, the fetus and the newborn, we focus this research in this clinical situation. The research project will be conducted in the Department of Anesthesiology at UNESP - Botucatu. A systematic review aiming to map all randomized controlled trials identified in major databases to assess the effectiveness of the triggers for blood transfusion in obstetric patients will be performed. The following databases will be searched: PubMed, CENTRAL (the Cochrane Library), Embase and Lilacs. The analysis and data collection will be performed by two reviewers that will select potential studies. The protocol this systematic review will be recorded in Cochrane Pregnancy and Childbirth Group magazine Group the Cochrane Database of Systematic Review, with 5.9 impact factor.