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Management of women who decline blood and blood products in pregnancy
Author(s) -
Currie Jane,
Hogg Matthew,
Patel Nandinee,
Madgwick Karen,
Yoong Wai
Publication year - 2010
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1576/toag.12.1.013.27553
Subject(s) - medicine , pregnancy , blood transfusion , obstetrics and gynaecology , obstetrics , blood loss , autonomy , intensive care medicine , surgery , genetics , political science , law , biology
• Women decline blood products in pregnancy for religious reasons or because of concerns regarding their safety. • Mortality is significantly increased in pregnant women who decline blood products. • Antenatal counselling and planning must involve a senior multidisciplinary team. • Considerable efforts are needed to optimise pre‐delivery haemoglobin and identify risk factors for haemorrhage. • Intrapartum techniques to avoid blood transfusion include cell salvage and early recourse to definitive surgical management in the event of massive obstetric haemorrhage.Learning objectives:• To understand the reasons why women decline blood and blood products in pregnancy and how this impacts on their health. • To understand the law relating to women who decline treatment in pregnancy. • To learn how to make the most of antenatal care opportunities. • To be able to plan labour and postpartum care. • To review the differences in managing massive obstetric haemorrhage between women who decline blood products and those who do not.Ethical issues:• Women's autonomy can be supported with accurate information and empathic counselling. • Given real concerns regarding the safety and availability of donor blood transfusion, should blood conservation techniques in obstetrics be applied to all women?Please cite this article as: Currie J, Hogg M, Patel N, Madgwick K, Yoong W. Management of women who decline blood and blood products in pregnancy. The Obstetrician & Gynaecologist 2010;12:13–20.