Background: Blood transfusion is an indispensable component of modern obstetric care, especially in managing complications such as postpartum hemorrhage and severe anemia. However, inappropriate or unnecessary transfusions can lead to increased patient risk, resource wastage, and strain on blood bank resources. This study aims to evaluate the current utilization patterns of blood and blood products in the Obstetrics and Gynecology department of a tertiary care hospital, with a focus on assessing appropriateness and identifying areas for improvement.

Materials and Methods: This prospective, observational study was conducted over 1.5 years at College of Medical Science Teaching Hospital Bharatpur, Nepal. All inpatients from the Department of Obstetrics and Gynecology who required blood transfusion during the study period were included. Data were collected using structured forms from blood request records and transfusion records. Key utilization indicators, including Crossmatch-to-Transfusion ratio (C/T ratio), Transfusion Probability (%T), and Transfusion Index (TI), were calculated and analyzed using Origin Pro version 8.0.

Results: Of the 330 patients for whom crossmatch requests were made, 200 patients (60.6%) received transfusions. A total of 745 units were requested, out of which 549 (73.6%) units were transfused. The most commonly transfused component was red blood cells (48.8%), followed by fresh frozen plasma (40.4%) and platelets (10.2%). Anemia complicating pregnancy was the most frequent indication for transfusion (51.5%), followed by Caesarean sections (26.1%). The C/T ratio was 1.65, reflecting moderately efficient blood utilization practices. However, 29% of transfusions were considered inappropriate based on hemoglobin levels, highlighting the need for stricter adherence to guidelines.