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Safety and efficacy of preoperative autologous blood donation for high‐risk pregnant women: Experience of a large university hospital in J apan
Author(s) -
Yamamoto Yasuhiro,
Yamashita Takahiro,
Tsuno Nelson Hirokazu,
Nagamatsu Takeshi,
Okochi Naoko,
Hyodo Hironobu,
Ikeda Toshiyuki,
Kawabata Michiru,
Kamei Yoshimasa,
Nagura Yutaka,
Sone Shinji,
Fujii Tomoyuki,
Takahashi Koki,
Kozuma Shiro
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12348
Subject(s) - medicine , autologous blood , blood transfusion , adverse effect , donation , blood bank , blood donor , obstetrics , pregnancy , surgery , blood pressure , emergency medicine , biology , immunology , economics , genetics , economic growth
Aim Preoperative autologous blood donation ( PAD ) has the advantages over allogeneic blood transfusion of theoretically no risk of viral infection and alloimmunization. However, there are some concerns regarding PAD in pregnant women, as they sometimes become anemic and adverse effects such as low blood pressure could be harmful to fetuses. In our hospital, the PAD program was implemented in 2006 and has been used in pregnant women at high risk of massive hemorrhage. In this study, the safety of PAD in pregnant women and its efficacy for avoiding allogeneic blood transfusion were investigated. Methods The hospital records of pregnant women who delivered at our hospital from J anuary 2009 to J une 2012 were reviewed and those who were enrolled in the PAD program for predicted massive hemorrhage were analyzed. Results Among the total of 3095 deliveries, 69 cases enrolled in the PAD program were analyzed. Blood donation was performed 189 times for the 69 cases. The median donated blood volume was 1200 m L (range, 400–2000). The mean blood loss during delivery was 1976 ± 1654 m L . Autologous blood was transfused in 64 cases. Allogeneic blood transfusion was required in five cases of massive blood loss exceeding 5000 m L . In the other 64 cases, no additional allogeneic blood transfusion was required. No adverse events were observed in either the pregnant women or fetuses. Conclusion For pregnant women at a high risk of massive hemorrhage, our PAD program was safe and effective for avoiding allogeneic blood transfusion.