Background: Massive blood transfusion is a rare condition with rates ranging from 2.3 to 10.0 per 10,000 maternities. Massive transfusion, historically defined as the replacement by transfusion of 10 units of red cells in 24 hours.
Objectives: Evaluate the effects of MBT in obstetrics and its complications, and assess early and late complications.
Patients and methods: This 38-patients cohort study at Qena University Hospital ran from May 2022 through April 2023. MBT occurred when 10 red cells were transfused in 24 hours. MBT = 3 RBCs/1h. Parameters assessed included CBC, coagulation profile, liver and renal function, blood sugar, vital signs, CVP, blood loss, and BMI.  Resuscitation targets were Hb 7-9 g/dL, INR <1.5, platelets >50,000/mL, pH 7.35-7.45, CVP 8-12 mmHg. Post-operative monitoring included vital signs and lab tests.
Results: 85% of 38 patients (average age: 31.26 years) had placenta previa (57.89% centralis, 15.79%/21.05% G2/G3). Avg. BMI: 26.79 kg/m^2, GA: 34.37 weeks, blood loss: 2757.59 ml, transferred units: Pre-operative: SBP rose to 105.26 mmHg, DBP to 68.42, pulse rate steady at 86.21 bpm, K to 3.35 mmol/L, Hgb to 10.11 g/dL, and CVP to 9.37 mmHg. 10.53% hypothermia, 52.63% NICU hospitalization, 5.26% renal impairment, and 15.79% disseminated coagulopathy were complications. Post-operative DBP, CVP, and MBT negative associations were found.
Conclusion: Monitoring and managing MBT in placenta previa patients is crucial to reduce complications. Factors influencing transfusion needs include intraoperative blood loss, gestational age, diastolic blood pressure, hemoglobin, AST levels, pulse rate, pH, and CVP.