Blood transfusion practice in gynaecology and obstetrics : retrospective audit

Abstract

The practice of Group and Screen (GS) and Maximum Surgical Blood Ordering Schedules (MSBOS) for patients undergoing elective surgery, including gynaecological and obstetrical procedures, has been introduced in many hospital blood banks over the last 15 years ·to replace the unregulated routine pre-operative cross-match [1-4]. Moreover, national guidelines for implementation of a MSBOS now exist [5]. The aim of this policy is to improve blood utilisation without compromising the patient's safety, and this was validated in a number of studies [6-8]. The cross-match/transfusion ratio (CTR) is generally regarded as the single most important indicator of the effectiveness of transfusion practice [9, 10] and is significantly reduced after the introduction of the GS and MSBOS policy [3, 11, 12]. However, the periods of observation on which these studies were based were limited to a few months before and after the introduction of GS and MS BOS [9, 10, 13]. Our impression was that once the initial period in the studies passed, 'old habits' tended to reappear and we therefore undertook a retrospective study to establish whether the impact of the MS BOS is sustained for a long period following its introduction, in a particular area of transfusion practice.