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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
Author(s) -
Tanaka Hiroaki,
Katsuragi Shinji,
Osato Kazuhiro,
Hasegawa Junichi,
Nakata Masahiko,
Murakoshi Takeshi,
Yoshimatsu Jun,
Sekizawa Akihiko,
Kanayama Naohiro,
Ishiwata Isamu,
Ikeda Tomoaki
Publication year - 2016
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13856
Subject(s) - amniotic fluid embolism , medicine , fresh frozen plasma , coagulopathy , hysterectomy , odds ratio , obstetrics , blood transfusion , surgery , pregnancy , platelet , genetics , biology
BACKGROUND The 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 METHODS The 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 ratio ≥ 1) were compared between the survival and death groups. RESULTS A 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. CONCLUSION Transfusion with FFP:RBC ratio of 1 or more is associated with higher survival rate in women with AFE with coagulopathy.