Our experience of autotransfusion in the management of ruptured ectopic pregnancy

Abstract

Introduction : The objective of this study was to present our experience in the practice of self-transfusion during ruptured ectopic pregnancies.

Patients and methods: This was a cross-sectional study of a consecutive series of patients admitted and operated on for a ruptured ectopic pregnancy and who received blood transfusion in two Liberian hospitals. The study covered the period from January 2010 to December 2012 for the Redemption Hospital (n= 41 cases) and that from December 2014 to December 2015 for the Voinjama Regional Hospital (n= 6). These two hospitals are secondary level health facilities. The parameters studied concerned: socio-demographic characteristics, clinical aspects, methods of recovery of perioperative blood and postoperative outcomes. Perioperative blood recovery was performed using one of the following methods: abdominal trans puncture, laparotomy and mixed methods.

Results: We collected 47 cases divided between the Redemption Hospital (n=41) and the Voinjama Regional Hospital (n=6). The average age of the patients was 28 years Multi-gesture (36 cases) and multiparous (29 cases) were the most represented. The average age of pregnancies was 6 weeks of amenorhea. The average consultation time was 12 hours. The clinical picture was dominated by menstrual disorders and pelvic pain. Hemorrhagic shock was found in 76.60% of patients. Ultrasound was performed in 47%, the urinary dosage of 100% beta HCG. The average time before management was 45 minutes. The mixed blood sampling method was the most commonly used (57.44%). The average volume of blood transfused was 2 500 ml bags. The hemoglobin level in patients at discharge from hospital was 8.04 g/dl on average with extremes of 7 and 12 g/dl. In our series all patients had a favorable evolution. No adverse effect related to the transfusion was registered.

Conclusion: Blood autotransfusion is a simple, effective, less expensive and better adapted method in our disadvantaged structures.