Feasibility and safety of preoperative autologous blood donation for pregnant patients
- VernacularTitle:产前贮存式自体备血的可行性及对母儿安全影响的研究
- Author:
Manrong LI
;
Yimin DAI
;
Zhiqun WANG
;
Ning GU
;
Jie LI
;
Hong JIANG
;
Qiao WENG
;
Yali HU
;
Guijun YAN
- Publication Type:Journal Article
- Keywords:
Preoperative autologous blood donation;
Post-partum hemorrhage;
Placenta previa;
Rare blood type;
Anemia
- From:
Journal of Medical Postgraduates
2014;(10):1060-1064
- CountryChina
- Language:Chinese
-
Abstract:
Objective Preoperative autologous blood donation ( PABD) may reduce the need for allogeneic blood , but it may also cause a short massive blood loss in pregnant women , and its fetal and maternal safety has to be adequately assessed .This study was to evaluate the feasibility and safety of PABD for pregnant women and their fetuses . Methods A prospective observational study was conducted among the women who met the inclusion criteria and gave birth in Nanjing Drum Tower Hospital between January and December 2013 .According to the clinical validation of risk stratification criteria for peripartum hemorrhage of California 2013 , the ca-ses were classified into a low-, a medium-, and a high-risk group.Data on blood donation procedures , obstetric outcomes, and blood transfusions were collected after delivery for analysis . Results Totally, 92 pregnant women accomplished 115 blood donations .The median volumes of the donated blood were 300, 300, and 400 mL in the low-, medium-, and high-risk groups, respectively ( P>0.001).There were no significant changes in HR , SBP and SpO2 during the blood donation procedures (P>0.05) except for the fall of diastolic blood pressure by an average of 3.4 mmHg (P<0.05) at 5 minutes after blood collection, which was restored to normal later.Non-reassuring fetal heart rate patterns were not found in any of the cases .The levels of HB and HCT were remarkably lower af-ter donation than before it (P<0.05) but restored to normal before delivery in the PABD cases who donated once only (P>0.05), which were similar to those in the cases who donated twice , with no significant differences before and after the donation (P>0.05). Homologous blood transfusion was performed for 5 cases (17.9%) in the high-risk group, with the volume of blood loss >2000 mL in all the cases.All the newborns survived without asphyxia and there was no perinatal death . Conclusion PABD can provide timely autologous whole blood donation for pregnant women .Under strict management , PABD is feasible and safe for pregnant patients who are at a high risk for massive blood loss during delivery or have a rare type of blood no readily available .
